AN 


ILLT  STEATED    SYSTEM  \i 


BANDAGIA^a 


SELECTED  FROM  GOFFBES  PRECIS  DE  BANDAGES. 


BY  OKPEK  OF  THE  SlTiGEOX-GExNEFiA 


U  I  C  II  M  0  N  D  : 

18(j4. 


AN 


ILLUSTRATED    SYSTEM 


OF 


BANDAGI^^a. 


(SELECTED  FROM  GOFFRES  PRECIS  DE  BANDAGES.) 


BY  ORDER  OF  THE  SURGEON-GENERAL. 


RICHMOND: 

18«4. 


C  0  N  T  E  NjT  S . 


PAGE 

General  Description  of  Bandages 7 

Bandages  for  the  Head 14 

Bandages  for  the  Trunk .'. 26 

Bandages  for  Upper  Extremities 31 

Bandages  for  Lower  Extremities 38 

Explanation  of  Plates 47 


401980 


GENERAL  DESCEIPTION 


OK 


BANDAGES. 


Bandages  receive  names  from  their  composition ;  they  are 
termed  simjyle  when  composed  of  one  piece,  and  compoiuid 
when  composed  of  one  or  more  pieces,  whether  separate  or 
sewed  together.  The  diflferent  pieces  of  a  bandage  may  be 
simple,  or  split  into  a  number  of  tails,  or  perforated ;  some 
are  both  spAit  and  perforated.  . 

The  mode  of  application,  as  well  as  their  shape,  also  give 
names  to  bandages:  such  as  the  circular,  the  spjiral,  the  crossj 
the  spica,  the  invafjinated ,  iha  fgure  of  ei<jht,  the  T  handayCj 
etc.  The  appropriateness  of  these  names  is  sufficiently  indi- 
cated in  the  descriptive  application  of  each. 

There  is  another  system  of  bandaging,  to  which  the  French 
give  the  name  of  Linge  Plein,  executed  with  handkerchiefs, 
napkins,  cravats,  square  pieces  of  linen,  etc.  These  appliances 
do  not,  however,  justify  the  enthusiasm  of  their  patron,  M. 
Mayor.  They  answer  very  well  for  slings,  but  their  applica- 
tion cannot  be  made  sufficiently  uniform  to  serve  the  purposes 
of  support  afforded  by  the  ordinary  bandage. 


Bandages  are  a  kind  of  support,  whose  length  and  breadth 
ought  to  be  proportioned  to  the  parts  to  which  they  are  ap- 
plied, and  they  should  never  exceed  twelve  yards  in  length 
and  three  inches  in  breadth ;  bandages  longer  or  wider  than 
this  are  difficult  to  roll,  hard  to  maintain,  and  awkward  to 
apply.     Ordinary  bandages  are  from  one  and  a  half  to  two 


/fi£\M  €\G£\ 


and  a  half  inclies  broad  and  tliree  yards  long.  The  ends  of 
a  bandage  are  called  initial  and  termhial;  their  surfaces  in- 
ternal and  external;  and  their  borders  mperior  and  inferior. 

Bandages  may  be  prepared  with  the  tissues  of  hemp,  flax, 
cotton,  wool,  and  even  caoutchouc  The  English  prefer  wool- 
len bandages,  which,  according  to  them,  compress  without 
binding  tightly,  and  adapt  themselves,  by  their  elasticity,  to 
the  different  changes  of  volume  which  a  part  may  undergo, 
keep  up  an  equable  and  gentle  warmth,  and  preserve,  for  a 
long  time,  the  liquids  of  fomentation.  But,  despite  these 
aclvantnges,  they  are  little  employed  j  their  cost  is  too  great; 
they  become  easily  soiler' ;  shrink  when  washed,  and  absorb 
with  great  facility  putrid  matters,  of  which  it  is  very  difficult 
to  cleanse  them. 

The  bandages  most  commonly  employed  are  such  as  are 
made  from  lin^n  or  cotton.  When  they  are  not  intended  to 
come  in  contact  with  the  parts,  it  matters  but  little  whether 
they  are  made  of  linen  or  cotton;  in  the  contrary  case,  linen 
should  be  preferred  to  cotton,  which  heats  and  irritates  the 
delicate  and  susceptible  skin. 

Dr.  Gariel,  who  has  made  in  surgery  such  happy  applica- 
tions of  vulcanized  India-rubber,  has  proposed  bandages  made 
with  this  substance.  Experience  has  taught  us  that  their 
application  is  easy  and  uniform ;  but  their  expansion  by  heat, 
their  contraction  by  cold,  the  obstacle  which  they  oppose  to 
cutaneous  transpiration,  and,  above  all,  the  difficulty  of  regu- 
lating, in  an  adequate  manner,  the  degree  of  constriction, 
force  us  to  regard  them  as  only  calculated  to  fulfill  some  par- 
ticular indications. 

"Bandages,"  says  Hippocrates,  "should  be  light,  supple, 
clean,  without  seams  or  eminences,  strong,  in  order  that  they 
may  stand  traction,  or  even  offer  a  little  more  resistance."  It 
is  also  important  that  they  should  be  cut  by  a  straight  thread ; 
without  this,  their  edges  ravel,  become  fringed,  tangled,  and 
they  are  difficult  to  apply.  Unfortunately,  it  is  not  easy  to 
obtain  a  straight  thread ;  therefore,  it  has  been  proposed,  in 
place  of  it,  to  secure  each  edge  of  the  bandage  by  a  whip- 
stitch. This,  however,  is  difficult  to  effect ;  for,  if  the  stitch 
be  at  all  tight,  the  edges  of  the  bandage  offer  more  resistance 
than  its  body,  and  then  the  bandage  compresses  in  an  unequal 
manner  and  produces  often  intolerable  pain.  To  remedy  this 
!neonTenienoe„  the  Germans  fabricate  their  bandages  with  a 


OS   BANDAGING.  ^ 

loose,  Hf2;lit,  porous  tissue,  woven  like  Bilk  ribbon ;  that  is  to 
say,  with  a  long  horsehair  in  the  edges,  which  is  immediately 
withdrawn,  and  which  leaves,  instead  of  a  selvage,  a  series  of 
little  curls,  by  the  aid  of  whicb  they  stretch  and  take  with 
great  facility.  These  bandages  appear  to  be  exceedingly  con- 
venient; they  were  long  ago  recommended  by  Percy,  who 
gave  them  the  name  of  bnndes  houclecs,  and  they  have  been 
eulogized  by  all  authors  who  have  devoted  themselves  to  the 
subject  of  bandaging  It  would  be  desirable  to  have  them 
adopted  in  all  hospital  establishments,  where,  despite  the  ex- 
pense, bandages  are  so  defective. 

Sometimes  bandages  are  not  long  enough  and  have  to  be 
pieced  ;  this  operation  should  be  performed  with  care.  Two 
processes  may  be  adopted  :  in  the  first,  the  two  ends  are  laid 
one  upon  the  other  and  sewed  together  face  to  face ;  in  the 
second,  the  two  extremities  are  brought  together  and  secured 
by  a  seam  half  an  inch  from  their  edges,  each  end  being  then 
turned  back  upon  its  respective  bandage  and  sewed  down. 
There  is  no  preference  for  one  or  the  otlier  of  these  modes  of 
joining  a  bandage ;  both  of  them  enable  us  to  avoid  ridges 
and  inequalities,  and  are  preferable  to  other 'met hod :i  recom- 
mended by  certain  authors. 

In  order  to  be  abje  to  make  u.so  of  a  bandage,  it  li  indis- 
pensable to  roll  it, upon  itself  in  such  a  manner  as  to  give  it, 
cither  the  form  of  a  single  cylinder,  in  the  centre  of  which  is 
found  the  terminal  end,  while  the  initial  end  is  free,  or  in  the 
form  of  two  cylinders;  in  this  way  it  is  rolled  by  its  two  ends 
until  they  meet  at  a  given  point.  In  the  first  case,  it  is  called 
a  shujlc-hf'uded  roller ;  in  the  second,  it  is  called  a  douhU- 
hf'adrd  roller. 

It  is  not  such  an  easy  matter,  as  at  first  supposed,  to  roll  a 
bandage  well ;  a  good  deal  of  pains  ought,  therefore,  be  taken 
to  accustom  one's-self  to  it.  A  bandage  badly  rolled  yields 
and  escapes  from  the  fingers,  and  is  very  difficult  to  apply; 
when,  on  the  contrary,  it  is  well  rolled,  it  can  be  held  firmly, 
and  applied  with  mote  dexterity,  promptitude  and  precision. 
To  wind  a  bandage  well,  the  terminal  end  must  be  seized  and 
folded  four  or  five  times  upon  itself,  in  the  form  of  a  small 
roller,  which  is  seized  with  the  tliumb,  the  index  and  middle 
fingers  of  each  hand,  in  such  a  way  as  to  impress  several 
turns  of  rotation  upon  itself;  when  it  has  acquired  a  cert'tia 
volume,  its  axis  is  placed  between  the  pulp  of  the  thumb,  of 


10  ON   BANDA6IKG. 

the  second  and  third  fingers  of  the  left  hand,  while  the  por- 
tion not  rolled  is  seized  between  the  thumb  and  the  radial 
border  of  the  right  index,  in  order  to  stretch  and  direct  it. 
That  done,  the  roller  is  made  to  rotate  upon  itself  by  the  aid 
of  the  middle,  ring  and  little  fingers  of  the  right  hand,  which 
are  at  the  same  time  to  maintain  it  in  the  palm  of  the  same 
hand.  When  tbe  roller  has  been  made  to  execute  a  certain 
number  of  turns,  and  it  is  perceived  not  to  be  sufficiently 
tight,  it  must  be  held  immovable  between  the  fingers  of  the 
left  hand,  while  the  bandage  is  pulled  with  force  by  the  right 
hand.  If  a  single  traction  is  not  sufficient,  it  is  repeated  as 
often  as  necessary,  and  we  thus  succeed  in  giving  to  the 
bandage  the  firmness  necessary  for  its  proper  application. 

When  the  bandage  is  to  be  made  into  a  double-headed 
roller,  each  one  of  its  ends  is  rolled  in  the  same  manner  alter- 
nately until  they  meet;  ordinarily,  more  volume  is  given  to 
one  roller  than  the  other,  in  order  that  one  of  the  ends  may 
be  fixed  and  the  bandage  terminated  with  more  regularity. 

The  rules  relative  to  the  application  of  bandages  diff'er 
according  as  they  are  wound  in  one  or  two  rollers. 

To»  apply  regularly  the  single  roller  handage,  the  roller  must 
be  held  between  the  extremity  of  the  thumb  and  the  index 
and  middle  fingers  of  the  right  hand  (pi.  1 ,  A,  fig.  1),  un- 
wind it  lightly,  while  the  initial  end  is  held  upon  the  point 
diametrically  opposite  the  wound  with  the  pulp  of  the  thumb 
and  index  finger  of  the  left  hand  (b,  fig.  1  j ;  it  is  fixed  by  two 
or  three  circular  turns  (2,  3,  4,  fig.  2),  and  continued  until 
the  bandage  is  exhausted,  when  it  is  applied  to  a  part  entirely 
cylindrical ;  when,  on  the  contrary,  it  is  applied  to  a  conical 
part,  such  as  the  superior  or  inferior  limbs,  it  is  necessary,  in 
order  to  avoid  the  fannelsj  which  would  cause  the  bandage  to 
lose  all  of  its  solidity,  to  have  recourse  to  the  circumvolutions 
known  under  the  name  of  doloires,  which  are  interrupted  by 
what  are  called  reverses.  This  is  done  by  making  obliquely 
with  the  aid  of  the  left  thumb  (A,  fig.  2),  on  the  external  face 
of  the  bandage,  a  fold  upon  itself,  in  such  a  way  that  the 
superior  edge  becomes  inferior  (5,  5,  G,  6,  7,  7,  8,  8,  9,  9, 
fig.  2),  and  that  it  thus  becomes  appHed  alternately  upon  the 
one  and  the  other  faces. 

When  the  bandage  is  not  intended  to  cover  a  long  surface, 
you  may,  instead  of  securing  the  initial  end,  let  it  hang  free 
five  or  six  inches,  and  fix  it  thus  by  circular  turns,  avS  in  the 


ON    BANDAGING.  11 

preceding  process.  The  hanging  end  may  then  be  tied  to  the 
terminal,  and  thus  serve  to  finish  the  bandage  and  secure  its 
solidity. 

When  the  bandage  is  entirely  applied  it  may  be  secured, 
either  by  proceeding  as  we  have  just  intimated,  or  by  split- 
ting the  terminal  end  and  tieing  the  two  strips  which  result 
from  this  section,  or  by  means  of  a  needle  and  thread,  or, 
lastly,  which  is  the  most  usual,  by  means  of  pins.  "  They 
should  always,'^  says  M.  Gerdy,  ''be  attached  in  such  a  man- 
ner that  the  convexity  of  the  part  does  not  make  the  point 
salient;  that  the  latter,  concealed  in  the  thickness  of  the 
turns  of  the  bandage,  does  not  wound  either  the  patient  in 
the  interval,  or  the  surgeon  at  the  moment  of  the  dressing. 
Nor  should  the  point  of  the  pin  be  turned  towards  the  end  of 
the  bandage,  because,  if  the  points  of  the  pins  were  not  solidly 
fixed  by  traversing  alternately  the  end  of  the  bandage  and 
the  circular  turns  which  are  below,  they  would  ea^ly  become 
detached.'' 

Whatever  be  the  method  resorted  to,  the  last  turn  of  the 
bandage  must  be  fixed  at  a  point  diametrically  opposite  to  the 
part  injured  :  we  thu.^  avoid  the  pain  of  inconvenient  pres- 
sure; when  the  length  of  this  turn  is  insufiicient  for  follow- 
ing this  precept,  it  must  be  shortened  by  folding  it  back  to  a 
convenient  distance. 

The  application  of  the  double-roller  handaf/c  is  much  more 
difficult,  and  it  requires  a  good  deal  of  practice  to  succeed  iu 
executing  it  skillfully.  M.  Gerdy  being  of  all  authors  the  one 
who  has  given  the  best  precepts  with  regard  to  it,  we  will 
borrow  from  him  the  description  of  the  following  procedure, 
which  he  designates  under  the  name  of  hitercros&huj  hy  re- 
verse. We  have  endeavored  to  render  it  comprehensible  in 
figure  o,  plate  1,  and  in  the  smaller  figure  7,  plate  2. 

"  Seize,"  says  he,  '•'  the  two  rollers  with  both  hands,  apply 
the  external  face  of  the  bandage  over  one  of  the  points  of  cir- 
cumference of  the  part  to  be  covered  by  the  bandage ;  then 
unwind  at  the  same  time  and  in  an  equal  manner  the  two 
rollers  around  this  part  (1,  1',  pi.  1,  fig.  3),  until  you  have 
conducted  them  to  a  point  opposite  to  that  where  you  com- 
menced the  bandage  ;  there  deviate  obliquely  one  of  the  two 
rollers  above  or  below ;  continue,  on  the  contrary,  to  carry 
the  other  and  its  band,  following  a  horizontal  line,  until  this 
band  encounters  that  of  the  first,  cover  it  and  cross  it  by 


m,'  OS  'BX^sn.imm*:  • 

forming  witli  it  an  acute  angle;  then  return  and  reverse 
obliqiiely  the  first  roller  and  the  band  deviated  over  the  circu- 
lar which  covers  it  and  crosses  it  (plate  2,  minor  figure  7) ; 
then  make  the  two  rollers  follow  their  primitive  direction ; 
bring  them  back  a  little  above  the  point  of  departure,  and 
recommence  in  front  the  same  manoeuvre  made  behind  (2,  2^ 
pi.  1,  fig.  3) ;  go  on  in  this  way  to  the  end  of  the  band  (3,  3', 
4, 4',  pi.  1,  fig.  3),  and  secure  the  last  circumvolutions,  as  well 
as  one  of  the  ends,  by  horizontal  circular -turns  made  with  the 
most  voluminous  roller." 

Besides  the  manual  regulations  which  we  have  just  traced, 
the  application  of  bandages  is  subject  to  other  precepts,  the 
importance  of  which  we  cannot  too  strongly  enforce.  Thus 
the  surgeon  should  place  himself  in  snch  a  eouvenient  attitude 
and  in  such  a  manner  as  not  to  have  to  move  when  passing 
the  bandage  around  the  patient.  The  latter  should  be  placed 
in  the  most  «onvenienfc  position  for  sparing  him  pain,  and  in 
such  a  way  that  the  wounded  part  may  not  be  exposed  to  any 
jdstling  or  intemperate  pressure.  The  bandage  should  be 
neither  too  loose  nor  too  tight;  in  general,  all  those  which 
are  not  employed  with  a  view  to  compression,  should  only  be 
light  enough  to  insure  necessary  solidity.  Unfortunately,  it 
is  far  from  being  easy  to  hit  the  proper  degree  of  constric- 
tion ;  this  precision  can  only  be  acquired  by  habit  and  long 
practice  We  are  disposed  to  think  we  have  obtained  this 
point  when  the  parts  form  above  the  circumvolutions  a  slight 
pro'nun once,  soft,  easily  depressed,  and  not  painful  to  the 
touch.  When,  on  the  contrary,  the  parts  are  the  seat  of 
violet- colored  swelling,  numbness  and  lively  pain,  it  is  an  in- 
dication that  the  bandage  is  too  tight;  we  must  hasten  then 
to- relax  it,  in  order  to  avoid  the  development  of  gangrene. 
For  tlie  rest,  tlie  degree  of  constriction  given  to  the  bandage 
varies  p.ccording  to  its  humidity  or  dryness.  With  a  view  of 
obtaining  in  this  respect  fixed  rules,  A.  Berard  practised  some 
experiments,  of  which  the  following  is  the  result  : 

1st.  Whether  a  bandage  is  applied  dry  or  moistened,  the 
pressure  exercised  by  it  augments  with  the  number  of  turns 
that  it  describes;  if,  for  example,  Regnier's  dynanometre, 
upon  which  it  is  wound,  marks  eleven  degrees  at  the  tenth 
turn,  it  will  mark  a  little  more  at  the  fifteenth,  a  little  more 
still  at  the  twentieth. 

2d.   All  things  being  otherwise  equal,  a  moist  bandage 


presses  more  strongly  than  a  dry  one :  thus,  in  many  consecu- 
tive experiments,  the  game  bandage  has  been  seen,  applied 
dry  and  moist,  mark  two  or  three  more  degrees  in  the  f?econd 
case  than  in  the  first. 

3d.  A  bandage,  whether  applied  dry  or  wet,  gradually 
relaxee  in  such  a  way  that  the  pressure  exercised  by  it  di- 
minishes from  day  to  day;  but,  if  it  is  wet,  the  pressure 
diminishes  much  more  rapidly  and  completely,  because  this 
phenomenon  depends  at  once  upon  its  dei»iccation  and  relaxa- 
tion :  therefore,  the  pressure  exercised  by  a  dry  bandage  is 
less,  but  persists  longer,  and  is  more  uniform  :  that  obtained 
from  a  wet  bandage  is  greater,  more  unequal,  and  less  con- 
stant. 

4th.  When  a  dry  bandage  is  applied  and  left  in  place  for 
several  days,  the  pros^sure  descends  several  degrees :  if  the 
bandage  is  then  moistened  without  being  deranged,  it  tishtens 
rapidly  and  to  such  an  extent,  that  the  pressure  exceeds  the 
degree  that  it  had  attained  at  the  moment  of  application  ;  but 
in  proportion  as  the  apparatus  dries,  the  turns  of  the  bandage 
relax,  the  pressure  diminishes  anew,  talis  lower  than  ever,  and 
even  ceases  sometimes  entirely. 

Whatever  be  the  purposes  and  the  form  of  a  bandage,  the 
man  of  art  should  kno77  how  to  combine  eJBicacy  with  dex- 
terity and  elegance.  A  bandage  well  applied  inspires  more 
confidence,  re-assures  the  patient,  persuades  him  that  all  pos- 
sible care  has  been  taken  to  insure  his  cure,  and  gives,  at  the 
same  time,  a  good  opinion  of  the  surgeon.  In  that  we  should 
imitate  A.  Pare,  and  say,  with  him,  ''after  having  applied  a 
bandage,  we  should  see  that  it  has-  been  properly  doiuj,  that 
it  is  comely  to  the  view,  in  order  to  content  the  patients  and 
friends,  for  every  one  in  his  profession  should  embellish  his 
work  as  far  as  possible." 


BANDAGES  FOR  THE  HEAD. 


In  general,  all  bandages  of  the  head  flatter  and  please  the 
eye  when  they  are  well  applied,  but  they  are  difficult,  com- 
plicated, and  it  is  only  by  the  aid  of  frequent  practice  that 
we  succeed  in  giving  them  proper  regularity.  The  spherical 
form  of  the  head  and  the  presence  of  the  hair  favoring  the 
slipping  of  the  bandages,  we  are  generally  much  disposed  to 
apply  them  too  tightly  -,  it  is,  however,  very  essential  to  avoid 
this  excess,  for  they  then  become  oppressive,  occasion  severe 
pain,  and  may  often  cause  dangerous  complications.  The  best 
means  of  succeeding  is  to  first  cover  the  head  with  a  cap ;  this 
simple  precaution  will  enable  us  to  give  to  the  bandage  sufii- 
cient  solidity  without  increasing  the  constriction.  It  should 
be  employed  in  all  bandaging  for  the  head,  and  we  beg  the 
reader  to  remember  this  statement,  in  order  to  avoid  the 
monotony  of  repeating  it  at  each  description. 


CIRCULAR  FOR  THE  FOREHEAD  AND  EYES. 

Comi^osUion. — A  bandage  four  yards  long  and  from  one 
and  a  half  to  two  inches  broad. 

Application. — Cover  the  head  with  a  cap  and  fix  the  initial 
end  of  the  bandage  over  the  forehead  by  two  circular  turns ; 
then  descend  little  by  little  over  the  eyes,  making  four  or  five 
additional  circles;  mount  again  over  the  forehead,  make  a  last 
turn,  and  fasten  the  bandage  on  one  side  of  the  head  with  a 
pin. 

Uses. — This  bandage  is  exceedingly  simple.  It  is  used  to 
protect  the  eyes,  to  shade  them  from  the  contact  of  light, 
and  to  maintain  topical  applications  in  ophthalmia,  lachrymal 
fistula,  or  after  the  operation  for  cataract. 


BANDAGES   FOR    fBB    BEAD.  "  15 

CROSS  FOR  ONE  EYE.— FIRST  VARIETY. 

(Plate  2,  Figure  4.) 

Composition. — A  bandage  six  yards  long  and  from  one  and 
a  half  to  two  inches  broad. 

Application. — If  you  wish  to  cover  the  right  eye,  place  the 
initial  end  of  the  bandage  above  this  eye,  and  make  a  circular 
horizontal  turn  from  the  forehead,  passing  above  the  eyebrows 
and  the  ears  (1,  2).  Having  arrived  at  the  nape,  pass  under 
the  right  ear  and  come  towards  the  angle  of  the  lower  jaw ; 
from  thence  mount  obliquely  over  the  cheek,  the  internal 
angle  of  the  eye,  and  the  root  of  the  nose;  gain  the  left  parietal 
protuberance  (3),  re-descend  to  the  nape,  and  make  a  circular 
turn  of  the  forehead,(4);  returned  to  the  nape,  repeat  a  simi- 
lar oblique  and  a  similar  circular  turn  (5,  G),  taking  care  not 
to  cover  the  first  turns  of  the  bandage  more  than  half  way ; 
repeat  the  same  manoeuvre  two  or  three  times  (7,  8,  9),  and 
terminate  by  circular  turns  around  the  head  (10). 

Uses. — They  are  the  same  as  those  of  the  preceding  band- 
age. This  variety  for  the  eye  is  not  very  solid ;  it  requires 
to  be  watched  and  frequently  re-applied  It  will  be  under- 
stood, of  course,  that  if  the  bandage  is  intended  to  cover  the 
left  eye,  it  should  be  applied  in  an  inverse  sense. 

SECOND    VARIETY. 

(Plate  2,  Figure  5.) 

Composition. — A  bandage  from  seven  to  eight  yards  long 
and  from  one  and  a  half  to  two  inches  broad. 

Application. — If  it  is  the  right  eye  which  is  to  be  covered, 
leave  hanging  over  the  right  side  of  the  body  of  the  lower 
jaw  a  pendant  jet,  about  three-quarters  of  a  yard  in  length  ; 
then  carry  the  bandage  obliquely  over  the  cheek,  mounting 
towards  the  internal  angle  of  the  right  eye,  the  root  of  the 
nose,  the  forehead,  the  left  parietal  protuberance  (A,  1),  and 
descend  to  the  nape;  from  there  come  below  the  right  ear,  and 
fix,  by  a  semi-circle  of  the  neck  (a,  2),  the  pendant  (b,  1). 
Arrived  at  the  nape,  ascend  obliquely  above  the  right  ear, 
make  a  horizontal  circle  of  the  forehead  (a,  3)  to  fix  there  the; 
jet  (a,  1).  Keturned  to  the  nape,  pass  below  the  right  ear 
to  make  a  second  semi-circle  of  the  neck  (a,  4),  iii  order  to 


16  ON    BANDACMKG^ 

fix  the  jet  (b,  2),  that  you  have  taken  care  to  raise  as  far  as 
the  forehead,  before  the  passage  of  the  circular  turn.  From 
the  nape  return  to  the  forehead,  making  a  second  horizontal 
circle  (a,  5),  which  will  fix  the  jet  (b,  2).  Reverse  then  this 
jet,  in  the  form  of  an  ear,  over  the  circular  (a,  5'),  and  direct 
it  towards  the  neck  to  form  the  jet  (b,  3).  From  the  nape, 
make  a  third  semi-circle  of  the  neck  (A,  6),  which  will  fix 
the  jet  (b,  3).  Elevate  this  jet,  it  will  form  then  the  jet 
(b,  4),  destined  to  be  carried  upon  the  forehead,  when  a  third 
circle  of  the  forehead  (a,  7)  will  have  fixed  the  ear  of  the 
jets  (b,  2,  and  B,  3).  Then  fix  to  the  neck,  by  a  fourth  semi- 
circle (a,  8),  the  ear  formed  by  the  jets  (b,  3)  and  (e,  4), 
and  return  to  the  nape,  to  make  from  thence  a  fourth  circle 
of  the  forehead  (a,  9).  Reverse  upon  this  circle,  in  the  form 
of  an  ear  (b,  5),  what  remains  of  the  tliiee-quarters  of  a  yard 
forming  the  pendant  jet,  and  floish  by  circular  turns  around 
the  head  with  the  roller  (a,  lU). 

Uses. — This  bandage  is  much  more  solid  than  the  pre- 
ceding ;  it  should  be  employed  in  all  cases  where  it  is  neces- 
sary to  exercise  pressure  over  the  fionto-ooulo-nasal  region. 

CROSS  FOR  BOTH  EYES.— FIRST  VARIETY,  WITH  ONE 
ROLLER. 

(Plate  2,  Figure  6.) 

Composition. — A  bandage  from  seven  to  eight  yards  long 
and  from  one  and  a  half  to  two  inches  broad. 

Application. — Place  the  initial  end  of  the  bandage  above 
the  right  eyebrow,  and  fix  it  by  a  horizontal  circular  turn 
around  the  forehead  (I,  2).  Arrived  at  the  nape,  pass  below 
the  right  ear,  gain  the  angle  of  the  right  lower  jaw;  ascend 
obliquely  over  the  cheek,  the  internal  angle  of  the  eye,  and 
the  left  parietal  protuberance,  taking  the  precaution  to  pass 
the  bandage  between  it  and  the  pavilion  of  the  ear  (3).  From 
thence  gain  the  nape,  ascend  obliquely  towards  the  summit  of 
the  right  parietal  protuberance,  descend  towards  the  root  of 
the  nose,  the  externa]  angle  of  the  left  eye,  and  the  left  angle 
of  the  lower  jaw  (4).  Return  then  to  the  nape,  and  fix  the 
two  obliques  by  a  circle  around  the  forehead  (5).  The  nape 
reached,  gain  the  right  angle  of  the  lower  jaw,  and  make  a 
second  oblique,  which  will  cover  the  first  for  two-thirds,  from 
the  internal  angle  of  the  eye  towards  the  external  angle  (6) ; 


gain  the  left  parietal  protuberance,  and  cover  the  ^rst  plane 
of  bandage  from  below  upwards;  regain  then  the  right  parie- 
tal protuberance  by  acting  in  an  inverse  sense — that  is  to  say, 
by  covering  the  plane  of  the  bandage  (4)  from  above  down- 
wards (7);  cover  the  left  eye,  make  a  fourth  circle  of  the 
forehead  (8),  then  two  new  obliques  (9,  lOj,  and  terminate 
by  circular  turns  around  the  forehead  (11). 

SECOND  TARIETY,  WITH  THE  DOUBLE  ROLLER. 

(Plate  2,  Figures  7  and  Minor  T.) 

Composition. — A  bandage  eight  yards  long,  by  one  and  a 
half  to  two  inches  broad,  rolled  into  two  heads  of  unequal 
size. 

Application. — Place  the  face  of  the  bandage  upon  the  an- 
terior and  middle  part  of  the  forehead,  above  the  eyebrows 
(1,  T);  direct  the  two  rollers  above  the  cars,  descend  lo  the 
na|,e,  intercross  the  two  rollers  by  reversinsr  the  inferior  (1,  2, 
minor  fig.  7)  upon  the  superior  (!',  2',  minor  fig.  7 ).  Change 
them  from  hand  to  hand,  bring  them  back  upon  the  angles  of 
the  jaw,  ascend  obliquely  over  the  cheeks  and  the  root  of  the 
nose,  where  you  will  intercross  in  the  form  of  an  X,  by  pass- 
ing the  one  held  in  the  right  hand  below  the  other  (2,  2'). 
Change  hands  with  the  rollers,  and  direct  them  over  the 
parietal  protuberances,  in  order  to  descend  to  the  posterior 
part  of  the  occiput,  where  you  will  intercross  them  again  by 
repeating  the  reverse.  From  thence,  after  having  changed 
hands  again  with  the  rollers,  bring  them  back  horizontally 
over  the  forehead,  where  you  will  intercross  them  by  reversing 
the  inferior  over  the  superior  (8,  8');  conduct  them  to  the 
nape,  in  order,  after  having  crossed  them,  to  bring  them  back 
over  the  angles  of  the  jaw.  Repeat  in  this  way,  four  or  five 
times,  the  intercrossings  at  the  nape,  the  X  of  the  nose  and 
the  horizontals  of  the  forehead  (4,  4',  5,  5',  6,  6',  7,  7',  !^,  8' ), 
and  terminate  by  circular  turns  around  the  head,  in  order  to 
i^cure  the  diflferent  planes  of  the  bandage,  as  indicated  at 
page  8. 

Uses. — The  double  cross  fulfills  for  both  eyes  the  same  in- 
dications as  in  the  single  cross  for  one  eye.  The  first  variety 
is  far  less  solid  than  the  second ;  the  latter,  on  the  other  hand, 
is  much  more  difficult  of  application. 


18'  .      on   BANDAGIKG. 


SIMPLE  CROSS  FOR  THE  LOWER  JAW. 

(Plate  3,  Figure  8.) 

Composition, — A  bandage  eight  yards  long,  by  one  and  a 
half  to  two  inches  broad. 

Application. — Make  two  horizontal  circular  turns  of  the 
forehead  (1,  2).  Arrived  at  the  nape,  pass  under  the  right 
ear,  if  the  disease  for  which  the  bandage  is  applied  is  on  the 
left  side,  and  vice  versa  if  it  is  on  the  right;  then  under  the 
chin ;  from  whence  you  will  mount  towards  the  left  temple 
in  passing  over  the  angle  of  the  jaw;  from  then.ce  ascend 
directly,  between  the  anterior  part  of  the  ear  and  the  external 
angle  of  the  eye,  to  the  vertex  (3) ;  from  whence  you  will 
take  an  oblique  direction  towards  the  right  ear,  over  which 
you  will  pass  the  bandage :  then  pass  again  under  the  chin, 
to  return  to  the  vertex,  continuing  to  direct  the  bandage  be- 
tween the  left  ear  and  the  external  angle  of  the  orbit  (4) ; 
pass  again  over  the  right  ear,  return  under  the  chin  and  over 
the  vertex,  in  order  to  repeat  a  third  vertical  circle  (5). 
Having  arrived  under  the  chin,  direct  your  roller  towards 
the  nape  (6),  so  as  to  bring  it  back  to  the  forehead,  in  order 
to  make  a  horizontal  circle  (7) ;  arrived  at  the  nape,  conduct 
your  bandage  over  the  chin  by  passing  immediately  beneath 
the  lower  lip  (8) ;  make  a  second  circle  similar  to  this  last 
(9),  but  a  fraction  of  an  inch  lower.  From  the  nape,  pass 
under  the  chin,  taking  care  to  include  a  part  of  the  lower 
border  of  the  preceding  turn  between  it  and  the  ehin ;  then, 
after  having  made  a  fourth  and  fifth  vertical  circle  (10,  11), 
return  under  the  chin,  gain  the  nape  (12),  and  finish  by  cir- 
cular turns  around  the  head  (lo),. 

Uses. — This  bandage  is  em^t/loyed  to  insure  immobility  of 
the  lower  jaw  in  cases  of  fracture  and  luxation.  It  will  also 
answer  for  maintaining  topical  applications  upon  and  under 
the  chin,  as  well  as  over  the  parotid  region. 

DOUBLE  CROSS  FOR  THE  LOWER  JAW.— FIRST  VARIETY, 
WITH  ONE  ROLLER. 

(Plate  3,  Figure  9.) 

Composition. — A  bandage  ten  yards  long,  by  one  and  a 
half  to  two  inches  broad. 


BA^DAQSSTOB.   THE   HB^P.  19 

Application. — Make  two  horizontal  circular  turns  of  the 
forehead  (1,  2) ;  arrived  at  the  nape,  conduct  the  bandage 
obliquely  under  the  right  ear,  make  a  semi- circle  of  the  neck 
(3),  pass  under  the  chin,  then  cover  the  left  angle  of  the 
lower  jaw,  and  ascend,  in  passing  between  the  external  angle 
of  the  eye  and  the  anterior  part  of  the  ear,  towards  the  fore- 
head. Direct  then  your  bandage  obliquely  between  it  and 
the  summit  of  the  head,  so  as  to  reach  the  right  parietal  pro- 
tuberance and  the  nape  (4) ;  i'rom  thence  come  over  the  left 
parietal  protuberance,  pass  again  between  the  forehead  and 
the  summit  of  the  head,  and  descend,  after  having  crossed 
the  turn  (4),  under  the  chin  in  passing  behind  the  right  angle 
of  the  lower  jaw  (5).  From  the  chin,  pass  again  over  the 
left  angle  of  the  lower  jaw,  ascend  again  to  the  forehead,  re- 
gain obliquely  the  nape  (6),  the  left  parietal  protuberance, 
the  right  angle  of  the  lower  jaw  and  the  chin  (7),  in  crossing 
the  turn  (G).  From  the  chin,  pass  again,  for  the  third  time, 
over  the  left  angle  of  the  lower  jaw,  so  as  to  ascend  again  to 
the  forehead ;  descend  to  the  nape  (><).,  return  over  the  left 
parietal  protuberance,  over  the  right  angle  of  the  lower  jaw, 
and  redescend  to  the  chin  (9),  in  such  a  way  as  to  have  three 
vertical  obliques  behind  each  angle  of  the  jaw  and  six  obliques 
between  the  forehead  and  the  summit  of  the  head.  From  the 
chin,  gain  the  nape ;  then  make  a  horizontal  circle  of  the 
forehead  (10),  in  order  to  fill  all  the  turns;  arrived  at  the 
nape,  make  a  circle  of  the  neck  (11)  j  then,  when  this  circle 
shall  have  reached  the  nape,  conduct  the  bandage  directly 
beneath  the  right  ear,  from  thcDce  over  the  chin,  in  passing 
immediately  beneath  the  lower  lip  (12).  Repeat  this  opera- 
tion a  second  time,  as  for  the  simple  cross  (13);  then  make 
a  semi-circle  of  the  neck  (14)  so  as  to  gain  the  left  angle  of 
the  jaw;  ascend  again  to  the  forehead,  descend  obliquely  to 
the  nape  (15),  pass  over  the  left  parietal  protuberance,  the 
right  angle  of  the  lower  jaw,  under  the  chin  (16),  over  the 
left  angle  of  the  lower  jaw,  and  ascend  again  between  the 
forehead  and  the  summit  of  the  head ;  gain  the  nape  (17), 
the  left  parietal  protuberance,  redescend  under  the  chin  (18), 
and  terminate  by  circular  turns  around  the  head  (19). 

C'ses. — This  bandage  is  employed  in  cases  of  luxation  or  of 
double  fractures  of  the  body  and  neck  of  the  lower  jaw.  Ap- 
plied as  we  have  just  described  it,  this  bandage  is  much  more 


eompKcated,  but  unicli  more  durable^  than  that  recommended 
byThillaye. 

SECOND  VARIETY,  WITH  THE  DOUBLE  ROLLER. 
(Plate  3,  Figueb  10.) 

Composition, — A  bandage  twelve  yards  long,  one  and  a  half 
to  two  inches  broad,  rolled  into  two  heads  of  unequal  size. 

Application. — After  having  applied  the  face  of  the  bandage 
intermediate  between  the  two  rollers  over  the  middle  of  the 
forehead  (1,  1');  direct  the  rollers  obliquely  above  the  ears  so 
as  to  descend  to  the  nape^  where  you  will  intercross  them  in 
changing  them  from  hand  to  hand ;  from  thence  carry  them 
under  the  chin  {21),  where  you  will  intercross  them  by  simply 
passing  one  below  the  other,  so  as  to  mount  to  the  right  and 
the  left  in  covering  the  angles  of  the  lower  jaw,  as  far  as  the 
anterior  and  superior  part  of  the  forehead,  where  you  will 
intercross  them  anew  by  reversing  the  superior  (2,  2) ;  then 
carry  each  of  the  two  rollers  to  the  nape  in  making  the  in- 
ferior bandage  pass  between  the  right  parietal  protuberance 
and  the  ear  (3')  and  the  bandage  which  has  been  reversed 
over  the  left  parietal  protuberance.  At  the  nape,  intercross 
each  roller  a  second  time  so  as  to  return  under  the  chin  (3) ; 
ascend  over  the  angles  of  the  lower  jaw,  intercross  them  over 
the  forehead  (4',  4'),  and  redescend  to  the  nape  (4) ;  from 
the  nape  return  a  third  time  under  the  chin  (5'),  over  the 
angles  of  the  lower  jaw,  the  forehead,  and  again  to  the  nape 
(5,  5),  in  acting  as  we  have  indicated.  Arrived  at  this  point, 
leave  the  bandage  which  ought  to  make  the  reverse  in  repose, 
and  make  with  the  one  which  covers  it  a  circle  around  the 
forehead  (6),  in  order  to  inclose  on  each  side  the  six  obliques; 
then,  when  the  circular  shall  have  returned  to  the  nape,  make 
the  reverse,  and  direct  the  two  rollers  simultaneously  in  front 
of  the. chin,  in  order  to  embrace  it;  these,  in  order  to  avoid 
puckering,  reverse  the  inferior  bandage  over  the  superior. 
From  the  chin,  direct  each  roller  towards  the  nape,  intercross 
them,  gain  the  under  part  of  the  chin  (8),  the  angles  of  the 
jaw,  the  forehead,  and  again  the  nape  (8',  8);  repeat  a  second 
time  the  same  manoeuvre  (9',  10, 10) ;  and  terminate  by  stop- 
ping the  roller  (11')  with  the  roller  (11),  which  should  make 
several  circular  turns  around  the  head,  in  order  to  secure  all 
the  circumvolutions. 


BANDAGJCS    FOU    THfc    HJtAD.  21 

Uses. — They  are  the  same  as  those  of  the  preceding  bandage. 
The  double  cross  for  the  jaw  with  two  rollers  is  still  more 
solid  than  that  applied  with  one  roller,  but  it  is  necessary  to 
employ  a  great  deal  of  care  in  its  applicatiou  which  is  exces- 
sively difficult. 

CROSS  FOR  THE  HEAD. 

(Platu  3.  Figure  11.) 

Composition. — A  bandage  six  yards  long,  by  one  and  a  half 
to  two  inches  broad. 

Application. — If  the  bandage  is  to  be  applied  over  the  right 
temple,  make  two  horizoutul*  circular  turns  around  the  fore- 
head, placing  the  initial  end  above  the  right  eyebrow  (1,  2) ; 
arrived  behind  thr^  right  oar.  secure  the  turn  with  a  pin,  and 
make  a  reverse  with  it  from  above  downwards  (o),  in  order  to 
direct  the  bandage  under  the  chin.  From  thence  mount  by 
passing  over  the  left  ear  to  the  vertex,  descend  to  the  right, 
covering  half  of  the  reverse,  regain  the  under  part  of  the 
chin  (4),  so  as  to  make  in  the  same  manner  three  or  four 
vertical  circles,  or  even  more,  if  necessary  (5,  0,  7,  8).  "When 
the  parts  are  sufficiently  covered,  secure  the  last  vertical  circle 
in  front  of  the  temple  with  a  pin,  then  make  a  second  re- 
verse (0),  in  order  to  direct  the  bandage  towards  the  opposite 
temple,  and  maintain  the  whole  by  horizontal  circular  turns 
around  the  forehead. 

0'.>\. — This  bandage  is  very  convenient;  it  is  frequently 
emploj'ed  to  maintain  topical  applications  in  di>cases  of  the 
ear,  of  the  parotid  gland,  and  of  the  submaxillary  and  supra- 
hyoid regions. 

KNOTTED  BANDAGE  FOR  THE  HSAD— (BALERS  KNOT.) 

(Pi.AT^  4,  Figure  lU.) 

Composition. — A  bandage  ten  yards  long  by  one  and  a  half 
to  two  inches  broad,  made  into  two  rollers  of  unequal  size. 

Application. — ^ Apply  the  face  of  the  bandage  horizontally 
over  the  diseased  temple,  the  left  temple  f^r  example;  direct 
the  two  rollers  towards  the  right  temple  (1,  1')  where  you 
will  intercross  them  by  reversing  the  superior  over  the  infe- 
rior, then  bring  them  back  over  the  diseased  temple  (2,  2'). 


%2  ON   BANDAGING. 

these  form  an  car  by  twisting  one  over  the  other,  and  chang- 
ing their  direction  in  such  a  manner  that  one  may  be  directed 
under  the  chin  (3')  and  the  other  over  the  summit  of  the  head 
(3),  from  whence  they  will  come  to  be  intercrossed  again 
over  the  right  temple,  to  gain  a  second  time  the  under  surface 
of  the  chin,  the  summit  of  the  head  and  the  left  temple  (4,  4'). 
Form  then  a  second  ear  like  the  first,  but  in  an  inverse  sense, 
that  is  to  say  by  directing  the  rollers  horizontally,  the  one 
over  the  forehead  and  the  other  over  the  nape  (5,  5')  as  far 
as  the  right  temple,  from  whence,  after  having,^intercrosscd 
them,  they  will  be  brought  back  over  the  left  temple  (6,  6') 
to  make  there  a  third  ear  like  the  first  (7,  7'),  make  then  a 
fourth  ear  like  the  second  and  terminate  by  horizontal  circu- 
lar turns  around  the  forehead  with  the  aid  of  the  largest  roller. 
Uses. — This  bandage  is  recommended  for  exerting  com- 
pression in  the  case  of  lesion  of  the  temporal  artery ;  its  action 
is  aided  by  placing  on  each  side  of  the  wound  a  small  gradu- 
ated compress  (a,  e).  Destined  to  remain  in  place  until  the 
obliteration  of  the  artery  and  to  be  tighter  than  any  other  of 
the  head,  it  must  be  applied  with  care  and  watched  attentively 
in  order  to  avoid  the  accidents  which  too  great  a  compression 
might  occasion. 

RECURRENT  FOR  THE  HEAD— (CAPELIXE.) 
(Platk  4,  Figure  13.) 

Composition.'-^ A.  bandage  eight  yards  long  by  one  and  a 
half  to  two  inches  broad,  made  into  two  unequal  rollers. 

Aj^pliratioiL. — Apply  the  face  of  the  bandage  over  the  an- 
terior part  of  the  forehead  (1,  1'),  direct  the  rollers  above  the 
eyebrows  and  the  ears  in  descending  obliquely  to  the  nape 
where  you  will  intercross  them  by  reversing  the  inferior  over 
the  superior,  in  sueh  a  way  as  to  bring  the  first  from  the  oc- 
ciput to  the  root  of  the  nose  (2)  in  passing  over  the  summit 
of  the  head,  following  the  track  of  the  sagittal  suture  (the 
name  recurrent  is  given  to  this  turn  of  the  bandage).  Then 
make  with  the  second  a  horizontal  semi-circle  of  the  forehead 
(2)  in  order  to  fix  the  reversed  turn.  Thus  fixed,  this  is 
raised  up  over  the  circular  to  make  a  second  recurrent  which 
you  will  direct  this  time  from  the  forehead  to  the  nape  in 
going  from  left  to  right  and  in  covering  the  first  for  the  third 
of  its  breadth  (3);  fix  to  the  nape  this  second  recurrent  by  a 


BAITOAGES    POTv    THE    HEAD.  '23 

horizontal  semi-circle,  make  a  third  reversed  turn  towards  the 
forehead  in  directing  it  from  right  to  left  (4)  and  fix  it  by  a 
horizontal  semi-circle  (3').  Continue  thus,  and  make  suc- 
cessively from  left  to  right  and  from  right  to  left  reversed 
turns  from  the  forehead  to  the  nape  and  from  the  nape  to  the 
forehead,  in  taking  care  to  dispose  them  in  the  form  of  slices 
of  melon  and  to  secure  them  by  circular  turns  until  the  head 
is  completely  covered  (5,  6,  7,  8,  9,  10,  11,  5'  6'),  then  ter- 
minate the  bandage  by  two  or  three  horizontal  circular  turns 
with  the  aid  of  the  roller  (7'). 

Cscs. — Recourse  is  had  to  this  bandage  in  case  of  wounds 
of  the  scalp,  to  support  the  sutures  or  topical  applications  to 
this  region.  It  is  a  very  elegant  bandage,  but  is  rarely  used, 
because  in  order  to  give  solidity  it  is  necessary  to  apply  it 
very  tightly. 

The  recurrent  of  the  head  may  also  be  executed  with  a  sin- 
gle roller ;  this  variety  does  not  differ  from  the  other  except 
in  the  manner  of  maintaining  the  reverse?.  We  will  describe 
it  in  detail  when  we  come  to  consider  the  bandages  for  ampu- 
tation,, for  which  it  is  more  particularly  employed. 

DOUBLE  T  FOR  THE  yO^E. 
(Plate  4,  Fi«uuk  U.) 

Componition. — A  bandage  two  yards  long  and  one  and  a 
quarter  inches  wide,  to  the  middle  of  which  is  sewed  perpen- 
dicularly, and  at  the  distance  of  one  and  a  quarter  inches 
one  from  the  other,  two  other  ))andagcs  half  a  yard  long  and 
Ibur-tit'ths  of  an  inch  broad. 

AppJication. — Apply  over  the  upper  lip  the" portion  of  the 
transverse  bandage  between  the  two  perpendicular  ones,  and 
conduct  each  extremity,  passing  below  the  ears  (b,  1,  1'),  to 
the  nape,  where  you  will  confide  them  to  an  assistant,  after 
having  intercrossed  themj  then  carry  obliquely  as  far  as  the 
root  of  the  nose  the  two  perpendicular  bands,  cross  them, 
carry  them  over  the  forehead  (A,  a),  the  summit  of  the  head, 
leaving  between  them  an  interval  of  one  and  a  quarter  inches. 
From  the  summit  of  the  head  direct  them  towards  the  nape, 
when  you  will  secure  them  by  a  knot,  after  having  passed 
them  the  one  beneath,  the  other  above  the  transverse  band. 
Then  take  the  two  rollers  of  the  latter  (b',  b*),  from  the 
hands  of  the  assistant,  and  bring  them  around  the  forehead, 


14  ON      HANUAUINU. 

to  be  secured  hy  a  pin  after  making  one  or  two  horizontal 
circular  turns. 

Uses.-— Th\8  bandage  is  used  to  sustain  the  dressings  after 
a  rhinoplastic  operation,  or  for  the  treatment  of  fracture  of 
the  bones  of  the  none  proper. 

INVAGINATED  OR  UNITINC;  BANDAGE  FOR  VERTICAL 
^      WOUNDS  OF  THE  LIP. 

(Plate  4,  Figurs  15). 

Qymposition. — 1st.  A  bandaare  three  yards  long  and  four- 
fifths  of  an  inch  wide,  made  into  a  double  roller.  2d.  A  long, 
double  corapres-^,  one  and  a  half  yards  long  and  two  and  a 
half  inches  broad.  3d.  Two  graduated  prismatic  compresses-, 
two  and  a  half  inches  lono:  and  one  and  a  half  inches  broad, 
and  having  a  thickness  of  from  two  and  half  to  three  inches, 
according  to  the  greater  or  less  i^alieucy  of  the  cheeks. 

Application.— WdtQ  the  graduated  compresses  (b,  b)  in 
the  hollow  below  the  check-bone,  half  an  inch  from  the  labial 
commissures ;  have  them  held  by  an  assistant  who,  placed 
behind  the  patient,  approsimates  them  as  much  as  possible 
without  deranging  them,  in  such  a  manner  as  to  relax  the 
upper  lip  ;  then  apply  the  centre  of  the  long  compress  over  the 
summit  of  the  head,  bring  the  extremities  under  the  chin 
in  passing  over  the  graduated  compresses,  and  have  them  held 
temporarily  by  the  hand  of  an  assistant  or  of  the  patient. 
Apply  then  the  centre  of  the  double  roller  bandage  over  the 
forehead  (1,  1'),  direct  the  two  rollers  to  the  nape,  from 
whence,  after  having  intercrossed  them  and  changed  hands, 
3^ou  will  bring  them  back  in  passing  above  the  long  compress 
and  the  graduated  compresses  which  the  assistant  then  ceases 
to  hold,  over  the  upper  lip,  at  the  centre  of  which  one  of  the 
pollers  will  pass  through  a  transverse  slit  previously  made  in 
one  of  the  bandages  (2.  2') )  then  draw  with  sufi&cient  force 
upon  the  rollers,  carry  them  back  to  the  nape  to  be  intercrossed 
again,  and  bring  them  back  a  second  time  in  front  of  the  up- 
per lip  (3,  3'),  then  to  the  nape  where  you  will  confide  them 
to  an  assistant.  That  done,  take  hold  yourself  of  the  ends  of 
the  long  compress,  cross  them  under  the  chin ;  carry  them, 
in  covering  on  both  sides  the  bandages  and  graduated  com- 
presses to  the  vertex,  where  you  will  intercross  them  once 
more  in  order  to  fix  them  over  the  temples  by  means  of  pins ; 


ean'dAgks  for  thk  head.  25 

then  take  hold  again  of  the  two  rollers  at  the  nape,  carry 
taVLXtS.  ""'"'' ''°'  ^™"*'*  ''  -era,''h;riz„S: 
Uses.— This  bandage  is  resorted  to  to  aid  the  action  of  su- 
( ores  in  approximating  the  edges  of  wounds  of  the  upper  lip, 
^^hethPr  after  a  traumatic  lesion,  or  after  the  operation  for 


BANDAGES  FOR  THE  TRUNK. 


FIGURE  OF  EIGHT  FOR  ONE  SHOULDER  AND  THE  OPPO- 
SITE AXILLA— ( SPICA  FOR  THE  SHOULDER.) 

(Plate  5,  Figure  16. )    . 

Composition. — A  bandage  eight  yards  long  and  two  inches 
broad. 

Application. — Place  the  initial  end  (1)  about  the  middle 
of  the  injured  arm — the  right  for  example — and  secure  it  by 
two  or  three  circular  turns  (2,  3 )  j  arrived  at  the  posterior 
and  internal  part  of  this  member,  ascend  behind  the  shoulder 
so  as  to  reach  its  superior  part ;  from  thence  descend  to  the 
axilla  of  the  sound  side,  by  passing  obliquely  in  front  of  the 
chest  (4),  ascend  obliquely  behind  the  back,  gain  the  supe- 
rior part  of  the  diseased  shoulder,  and  descend  under  the. 
axilla  of  the  same  side,  crossing  the  first  turn  (5,  5).  Ascend 
again  over  the  shoulder,  re-descend  to  the  sound  axilla,  ascend 
again  behind  the  back,  over  the  diseased  shoulder;  re-descend 
under  the  axilla  of  this  side,  and  continue  to  act  thus  (8,  9, 
9,  10,  10,  11,  11,  12,  12,  13,  13,  14)  until  the  bandage  is 
exhausted,  when  the  terminal  end  is  to  be  secured  to  one  of 
the  turns,  either  on  the  anterior  or  posterior  aspect  of  the 
chest.  Thus  applied,  this  bandage  constitutes  the  descending 
spictty  because  the  turns  of  the  bandage  cover  each  other  from 
above  downwards,  from  the  upper  part  of  the  shoulder  to  its 
lower;  it  may  be  applied  in  an  inverse  sense,  or  from  below 
upwards ;  it  then  takes  the  name  of  ascending  spica.  The 
first  appears  to  us  preferable,  being  firmer  and  more  regular. 

Uses. — This  bandage  serves  to  confine  applications  to  the 
upper  portion  of  the  sternum,  over  the  clavicle  and  the  sum- 
mit of  the  shoulder. 


BANDAGES   FOR    THK   TRU>K.  27, 

ai;terior  figure  of  eight  for  the  shoulders. 

(  Plate  5,  Figure  17.) 

Composition. — A  bandage  eight  yards  long  and  two  inches 
broad. 

Application. — Fix  the  initial  end  (1)  by  two  circular  turns 
at  the  upper  part  of  the  right  arm  (2,  3);  having  reached  the 
internal  and  posterior  part  of  this  member,  mount  behind  the 
right  shoulder  and  gain  its  superior  part;  then  guide  youself 
obliquely  in  front  of  the  chest,  so  as  to  descend  under  the 
left  axilla,  (4,  4),  ascend  behind  it,  thence  over  the  shoulder, 
and  descend,  crossing  the  first  turn,  under  the  right  axilla 
(5,  5).  Now  mount  again  over  the  shoulder  of  this  side,  pass 
obliquely  in  front  of  the  chest,  come  under  the  left  axilla 
((5,  6),  over  the  shoulder,  in  front  of  the  chest  to  reach  the 
right  axilla  by  crossing  the  preceding  turns  (7,  7),  and  con- 
tinue thus  until  there  is  a  sufficient  number  of  crosses  in  front 
of  the  sternum  (8,  8,  9,  9,  10).  Finish  the  bandage  by  se- 
curing the  terminal  end  indifferently  over  the  one  or  the  other 
shoulder. 

Uses. — This  bandage  serves  to  preserve  contact  of  the  frag- 
ments of  the  sternum  in  fractures  of  the  upper  part  of  this 
bone ;  it  is  also  employed  to  dress  burns  between  the  shoul- 
ders, in  order  to  prevent  bad  cicatrization  ]  lastly,  it  will  serve 
to  maintain  reduced  luxations  of  the  internal  end  of  the  clavi- 
cle forwards.  In  the  two  latter  circumstances,  its  object  is  to 
draw  the  shoulders  forward;  it  is  therefore  necessary  to  place 
them  in  this  position  before  commencing  it,  and  to  maintain 
them  so  by  the  aid  of  an  assistant  during  thcT whole  of  its  ap- 
plication. It  is  useful,  in  order  to  prevent  the  inconvenient 
pressure  exerted  in  front  and  especially  behind  the  axilla,  to 
protect  these  parts  with  wadding. 

CROSS  FOR  both  GL^OINS— (SPICA  FOR  BOfH  GROINS.) 
(Plate  6,  Figure  18.) 

Composition. — A  bandage  fourteen  yards  long  and  two  and 
a  half  inches  broad. 

Appjlication. — Make  first,  from  before  backwards  and  from 
right  to  left,  two  or  three  horizontal  circular  turns  around  the 
abdomen  (1,'2,  3);  having  arrived  above  the  ^crest  of  the 


'28  ON    BANDAGINO. 

rig"ht  ilium,  take  an  oblique  direction  towards  the  left  groin, 
and  gain  the  external  face  of  the  thigh  of  the  same  side 
(4,  4,  4) ;  pass  behind  it,  come  to  its  internal  side,  mount 
over  by  passing  over  the  left  groin  to  above  the  left  trochanter 
major  (5,  5);  make  behind  a  semi-circle  of  the  abdomen; 
arrived  over  the  right  trochanter  major,  descend  in  covering 
the  right  groin  to  the  internal  part  of  the  corresponding 
thigh  (6,  6) ;  wind  behind  it,  and  ascend  obliquely  towards 
the  crest  of  the  left  ilium  (7,  7,  7) ;  practise  a  posterior  ab- 
dominal semi-circle ;  then,  from  the  right  iliac  spine,  gain  the 
external  part  of  the  left  thigh  (8,  8,  8);  get  to  its  internal  side, 
ascend  to  the  left  trochanter  major  (9,  9),  practise  a  posterior 
abdominal  semi-circle,  pass  over  the  right  trochanter  major, 
descend  obliquely  to  the  internal  part  of  the  thigh  of  the  same 
side  (10,  10),  get  to  its  external  face,  and  ascend  over  the 
left  iliac  spine  (11,  11,  11) ;  continue  in  this  way  until  the 
groins  are  sufficiently  covered  (12,  12, 12, 18,  14, 14,  15, 15), 
then  terminate  with  the  roller  (16)  by  circles  around  the 
abdomen. 

Instead  of  making  the  cross  in  t^iis  way  by  ascending 
(ascending  spied),  it  may  be  executed,  as  in  the  succeed- 
ing case,  by  working  it  from  above  downwards  {descending 
sjpica). 

The  spica  for  both  groins  may  be  also  applied  with  a  double- 
headed  roller.  Fo»  this  purpose  the  centre  of  the  bandage  is 
placed  over  the  last  lumbar  vertebrae,  and  after  having  made 
two  or  three  circular  turns  around  the  abdomen,  crossing  the 
turns  alternately  in  front  and  behind,  one  of  the  rollers  is 
directed  from  right  to  left  and  the  other  from  left  to  right 
towards  the  iliac  spines;  from  thence  the  external  face  of 
each  thigh  is  gained,  crossing  the  bandage  above  the  pubis. 
Wind  round  the  posterior  face  of  each  thigh  and  gain  their 
internal  side;  ascend,  passing  obliquely  over  the  groins,  to 
the  great  trochanters,  and,  after  having  crossed  the  bandage 
over  the  loins,  direct  the  rollers  again  towards  the  iliac  spines, 
to  descend  again  towards  the  external  face  of  the  thighs,  re- 
ascend  over  the  groins,  gain  the  loins,  and  continue  thus  the 
number  of  turns  necessary  to  cover  the  injured  regions.  The 
cross  for  both  groins,  with  the  double  roller,  does  not  compen- 
sate by  any  advantage  the  difficulties  of  its  application;  it 
is  with  much  trouble,  and  only  by  subjecting  the  patient  to 
painful  movements,  that  we  can  make  the  crossing  over  the 


ba»dage6  for  thk  trl^-s  ^i9 

sacro-lumbar  region;    we,   therefore,  think  that  the  single- 
headed  roller  should  always  be  preferred. 

Uses. — The  spica  for  both  groins  answers  the  same  purposes 
as  the  preceding  when  both  groins  are  to  be  acted  on. 

CROSS  FOR  THE  GROIN— (SPICA  FOR  THE  GROIX.) 
(Plate  6,  Figure  19.) 

Composition.- — A  bandage  nine  yards  long  and  two  and  a 
half  inches  broad. 

Application. — The  spica  may  be  applied  either  to  the  left 
or  right  groin.  If  you  wish  to  cover  the  latter,  begin  from 
right  to  left  of  the  patient,  by  making  two  or  three  horizontal 
circular  turns  around  the  abdomen  (1,  2,  3);  then,  after  hav- 
ing made  the  bandage  pass  over  the  space  included  between 
the  great  trochanter  and  the  crest  of  the  ilium,  direct  it  ob- 
liquely towards  the  iaternal  part  of  the  corresponding  thigh 
(4,4);  from  there  pass  to  its  posterior  part,  following  the 
fold  of  the  buttock,  gain  its  external  part,  and  ascend  ob- 
liquely, crossing  over  the  first  turn  of  the  bandage,  towards 
the  great  trochanter  of  the  left  side  (5,  o).  Make  a  horizon- 
tal half-circle  behind  the  abdomen,  bring  back  your  bandage 
between  the  great  trochanter  and  the  crest  of  the  right  ilium, 
gain  obliquely  the  internal  part  of  the  thigh  in  covering  the 
first  turn  of  the  bandage  for  two-thirds  of  its  width  (6,  6j, 
make  a  contour  with  the  bandage  by  its  posterior  face,  come 
over  its  external  face,  and  ascend  obliquely  over  the  great 
trochanter  of  the  left  side  (7,  7) ;  make  a  new  contour  of  the 
abdomen  behind,  redescend  to  the  internal  part  of  the  right 
thigh,  mount  again  over  the  great  trochanter  of  the  left  side, 
make  a  third  posterior  abdominal  circle,  and  continue  thus  as 
often  as  may  be  necessary  for  covering  the  right  groin  com- 
pletely (8,  8,  9,  9,  10,  10,  11,  11,  12,  12,  13,  13,  14,  14,  15, 
15,  16,  16,  17,  17).  Finish,  lastly,  with  the  roller  (18)  by 
circular  turns  around  the  trunk. 

Uses. — This  bandage  may  be  employed  for  maintaining  topi- 
cal applications  and  all  sorts  of  dressings  over  the  groin;  it 
is,  nevertheless,  generally  reserved  for  those  circumstances  in 
which  it  is  necessary  to  exert  a  solid  and  regular  pressure 
over  this  region,  when  there  is  question,  for  example,  of  com- 
pressing engorged  glands,  producing  pressure  upon  fistulous 
tracts,  maintaining  a  hernia,  etc. ;  in  these  different  cases  it 


is  necessary  to  interpose  round,  oval  or  square  graduated  com- 
presses between  it  and  the  points  of  compression. 

Thus  applied,  this  bandage  constitutes  the  ascending  sjpica. 
The  descending  spica  is  executed  by,  instead  of  directing  the 
first  oblique  towards  the  point  where  you  wish  the  bandage 
to  stop  below,  placing  it  at  the  superior  part  of  the  thigh,  and 
continuing  the  crosses  from  above  downwards.  These  two 
modes  of  application  of  the  spica  for  the  groin  may  be  indif- 
ferently employed ;  there  is  no  reason,  that  we  can  perceive, 
for  prefering  the  one  over  the  other. 


BANDAGES  FOR  UPPER  EXTREMITIES. 


SPIRAL  FOR  OXE  FINGER. 

(Plate  7,  Figure  20.) 


Compositioi}. — A  bandage  one  and  a  half  yards  long  and 
about  an  inch  wide. 

Application  — If  you  wish  to  cover  one  of  the  fingers  of  the 
right  hand,  after  having  placed  the  hand  in  a  state  of  prona- 
tion, leave  several  inches  of  the  initial  end  hanging  on  the 
ulnar  side  of  the  wrist,  and  make  two  or  three  circular  turns 
around  it  (1,  'jJ)  ;  having  arrived  at  the  articulation  of  the 
fifth  metacarpal  bone  with  the  unciform,  descend  obliquely 
towards  the  external  side  of  the  base  of  thej finger  (3,  3), 
make  several  digressing  turns  to  gain  the  end  of  the  finger  (4), 
from  whence  you  will  ascend  to  its  base  by  making  successive 
turns  covering  each  other  for  two-thirds  of  their  width  (5,  6, 
7,  8,  9,  10,  11);  then,  when  the  last  turn  shall  have  reached 
the  internal  side  of  the  finger,  pass  over  the  back  of  the  hand, 
wind  round  the  first  metacarpal  bone  about  its  middle  (12), 
and  reach  the  ulnar  side  of  the  wrist  (13),  where  you  will  tie 
the  initial  and  terminal  ends  together  (14,  15). 

Uses. — This  bandage  serves  to  exercise  compression  and 
maintain  dressing  around  the  finger. 

SPIRAL  FOR  THE  FINGERS  AND  HAND. 

(Plate  7,  Figure  21.)    . 

Composition. — A  bandage  three  yards  long  and  one  and  a 
half  inches  wide. 

Application. — Fix  the  initial  end  at  the  extremity  of  the 
fingers  (1,  2);  ascend  from  thence  towards  the  wrist,  making, 
at  the  base  of  the  thumb,  proper  reverses,  so  as  to  give  to  the 


2r2  O^    BAiiDAGIKO. 

bandage  sufficient  solidity  and  regularity  (3,  4,  5,  6,  7,  8,  9, 9, 
10,  10,  11,  11,  12,  12,  13,  13,  14,  14,  15,  15),  and  finish  by 
circular  turns  around  the  wrist  (16,  17,  18). 

jjges. — The  spiral  of  the  fingers  and  hand  serves  to  main- 
tain the  apparatus  in  fractures  and  luxations  of  the  fingers 
and  bones  of  the  hand. 

FIGURE  OF  EIGHT  FOR  THE  THUMB  AND  WRIST—(SPICA 
FOR  THE  THUMB.) 

(Plate  7,  Figure  22.) 

Composition.— K  bandage  two  yards  long  and  four-fifths  of 
an  inch  broad. 

Application.— 'Mi^x  having  placed  the  hand  in  a  state  of 
semi-pronation,  allow  to  hang  on  the  ulnar  side  of  the  fore- 
arm, if  it  is  the  right  wrist  and  thumb  that  you  wish  to  cover, 
several  inches  of  the  initial  end,  gain  the  radial  side  of  the 
wrist,  and  make  one  or  two  circular  turns  around  it  (1,  2,  3); 
having  reached  the  upper  extremity  ef  the  fifth  metacarpal 
bone,  descend  obliquely  towards  the  external  side  of  the 
articulation  of  the  first  with  the  second  phalanx  of  the  thumb 
(4,  4),  come  to  its  internal  side  and  ascend,  crossing  the  first 
turn,  to  the  ^ternal  side  of  the  lower  extremity  of  the  first 
metacarpal  bone  (5,  5)j  then  make  a  horizontal  semi- circle 
over  the  palmar  surface  of  the  wrist,  so  as  to  bring  the  band- 
age over  the  carpal  articulation  of  the  fifth  metacarpal  bone ; 
from  thence  gain  obliquely  the  external  face  of  the  second 
phalanx  of  the  thumb,  covering  the  oblique  (4)  two-thirds 
(6,  6) ;  come  again  to  the  internal  side  of  t^hts  phalanx,  and 
ascend  a  second  time  obliquely  towards  the  middle  and  exter- 
nal side  of  the  first  metacarpal  bone  (7,  7);  go  again  over  the 
palmar  face  of  the  wrist,  redesccnd  to  the  external  part  of 
the  base  of  the  thumb  (8,  8),  ascend  again  over  the  lower 
extremity' of  the  first  metacarpal  bone  (9,  9),  make  a  third 
semi-circle  of  the  wrist;  then^  after  having  continued  the 
obliques  around  the  thumb  until  its  metacarpo-phalangeal 
articulation  is  completely  covered  (10,  10, 11,  11,  12, 12,  13, 
13,  14,  14,  15,  15),  come  again  to  the  ulnar  side  of  the  fore- 
arm, where  you  will  tie  together  the  terminal  end  (16)  with 
the  initial  end. 

i[7ses.-— This  bandage  is  used  in  the  dressing  of  lesions  of 
tha  metacarpo-phalangeal  articulation  of  the  thumb  j   it  is 


BAN-DAGES    FOR    CPPBR    EXTREMITIKS.  S3 

farther  useful  to  secure  extension  of  this  member  after  reduc- 
tion of  the  luxation  backwards  of  the  first  metacarpal  boRe 
from  the  trapezium.  Like  all  the  spicas,  it  may  be  applied 
from  above  downwards;  that  is  to  say,  in  directing  the  crosses 
ftom  the  base  towards  the  summit  of  the  thumb ;  but  this 
desrtnding  spica  is  much  less  regular  than  the  ascending  spica, 
which  we  have  just  described. 

* 

POSTEPJOR  Fiar-RE  OF  EIGHT  FOR  THE  HAND  AND  WRIST. 
(  Plats  7,  Figure  23.) 

Composition. — A  bandage  two  and  a  half  yards  long  and 
one  and  a  half  inches  wide. 

Appliration . — Place  the  hand  in  a  state  of  pronation,  and 
fix  the  initial  end  of  the  bandage  over  the  dorsal  aspect  of  the' 
wrist  by  a  horizontal  circular  turn  (1,  2),  following  the  direc- 
tion from  the  radius  to  the  ulna,  if  the  bandage  is  applied  to 
the  left  hand,  then  carry  the  roller  obliquely  over  the  back 
of  the  hand ;  from  thence  conduct  it,  after  having  made  a 
horizontal  circular  turn  around  the  fingers  (4),  between  the 
thumb  and  the  index  finger,  from  whence  you  will  ascend 
obliquely  over  the  back  of  the  hand  (5,  5),  crossing  the  turn 
(8);  make  a  horizontal  circle  around  the  wrist  (6),  repass 
obliquely  over  the  back  of  the  hand  (7,  7,)  circularly  around 
the  base  of  the  fingers  (8),  come  again  between  the  thumb 
and  the  index  finger,  to  ascend  anew  obliquely  over  the  back 
of  the  hand  (9),  and,  after  having  continued  thus  until  the 
bandage  is  exhausted,  terminate  by  circular  turns  around  the 
wrist  (10). 

Uses. — Recourse  is  had  to  this  bandage  for  maintaining 
the  apparatus  over  the  dorsal  aspect  of  the  hand  and  wrist ; 
it  may  equally  serve  to  fix  a  graduated  compress,  destined  to 
exercise  compression,  whether  over  a  ganglion  or  over  the  03 
magnum,  after  reduction  of  its  luxation  backwards,  or  over 
the  salvatella.  to  arrest  the  flow  of  blood  after  bleeding  from 
this  vein. 

ANTERIOR  FIGURE  OF  EIGHT  FOR  THE  HAND  AND  WRIST. 

This  bandage  may  be  executed  like  the  preceding  one,  but 
in  making  the  crosses  over  the  palmar  face  of  the  band, 


34  OIv    BANDAGING. 

•which,  in  the  posterior  eight,  are  made  over  the  dorsal  aspect. 
It  serves  to  apply  dressings  to  the  palm  of  the  hand. 

FIGURE, OF  EIGHT  FOR  THE  ELBOW— (BANDAGE  FOR 
VENESECTION  FROM  THE  ARM.) 

(Plate  8,  Figure  24.) 

Composition. — A  bandage  two  and  a  half  yards  long  and 
one  and  a  half  inches  broad. 

Application  — Leave  a  tail  of  bandage^  ten  inches  long,  free 
over  the  external  and  lower  side  of  the  right  arm ;  then,  after 
having  directed  it  towards  the  internal  side,  fix  it  by  a  circu- 
lar turii  (2);  having  arrived  above  the  external  condyle,  gain 
obliquely  the  internal  and  upper  side  of  the  fore-arm  (3),  sur- 
round it  with  a  horizontal  circle  (4),  and  ascend  obliquely,  in 
crossing  in  front  of  the  bend  of  the  arm,  the  turn  (3),  as  far 
as  the  internal  condyle  (5) ;  make  a  horizontal  semi-circle 
backwards,  pass  again  over  the  fold  of  the  arm  (6),  circularly 
behind  the  fore-arm ;  mount  again  obUquely  towards  the  in- 
ternal condyle  (7),  and  terminate  by  tying  the  terminal  end  (8) 
and  the  initial  end  together  on  the  outside  of  the  arm. 

Uses.: — The  eight  bandage  for  the  elbow  is  in  daily  use  to 
secure  the  small  compress  placed  over  the  vein  after  venesec- 
tion from  the  arm ;  its  circumvolutions  leave  full  liberty  of 
motion  to  the  elbow,  and  allow  it  to  be  maintained  in  a  semi- 
flexed position  until  the  healing  of  the  wound. 

FIGURE  OF  EIGHT  FOR  EXTENDING  THE  HAND  UPON  THE 
FORE-ARM. 


Composition. — A  bandage,  five  yards  long  and  one  and  a 
half  inches  broad,  made  into  a  double-headed  roller. 

Application. — After  having  placed  the  hand  in  the  ex- 
tended position,  apply  the  intermediate  face  of  the  bandage 
over  the  dorsal  aspect,  then  direct  the  two  rollers  towards  the 
palmar  face  (1, 1'),  where  you  will  cross  them,  changing  them 
from  hand  to  hand;  from  there  bring  them  back  over  the 
dorsal  aspect,  where  you  will  cross  them  anew  (2,  2'),  so  as 
to  conduct  them  and  cross  them  again  over  the  palmar  sur- 
face ;  direct  them  then  obliquely  the  one  above  the  external 
condyle  (o,  3)^  the  other  above  the  internal  condyle  (3'  3'), 


■   BANDAGES    FOR    VVVStH    EYTRENfTTrcs.  H5 

crossing  them,  like  the  letter  X,  at  the  middle  of  the  fore- 
arm,  make  a  horizontal  circle  with  your  two  rollers  above  the 
elbow  (4,  4') ;  come  again  above  the  external  and  internal 
condyles,  descend  obliquely  towards  the  hand,  crossing  the 
turns  again,  like  the  letter  X,  at  the  middle  of  the  fore-arm 
(5,  5,  5',  5') ;  cross  your  bands  over  the  palm  of  the  hand 
(6,  6'),  and  finish  by  ascending  towards  the  elbow  and  de- 
scending towards  the  hand  until  the  bandage  is  exhausted. 
.  Uses. — This  bandage  is  employed,  in  the  case  of  burns  of 
the  palmar  aspect  of  the  hand  and  wrist,  to  prevent  flexion 
of  the  parts  from  contraction  of  the  cicatrices. 

FIGURE  OF    EIGHT    FOR  FLEXING    TTTK   TT  \  vn    rPOX  THE 
FORE-ARM. 

When  the  burns  are  situated  upon  the  back  of  the  wrist  or 
hand,  if  you  wish  to  iffevent  contraction  of  the  cicatrices  from 
producing  extension  of  the  hand  upon  the  fore-arm,  the  flex- 
ing figure  of  eight  for  the  hand  must  be  resorted  to.  In  or- 
der to  apply  it,  the  hand  is  placed  in  the  flexed  position,  and 
the  intermediate  face  of  the  bandage  between  the  two  rollers 
is  placed  over  the  palmar  surface;  the  two  rollers  are  then 
directed  towards  the  dorsal  aspect,  then  again  towards  the 
palm,  fpom  the  hand  towards  the  elbow  and  from  the  elbow 
towards  the  hand,  alternately  representing  the  letter  X  over 
the  middle  of  the  ^terior  surface  of  the  fore-arm. 

RECURRENT  OR  CAPELIXE  FOR  DISARTICULATION  OF  THE 
SHOULDER.JOINT. 

(Plate  8,  Figure  26.) 

Composition. — A  bandage  twelve  yards  long  and  one  and  a 
half  inches  broad,  made  into  a  double-headed  roller. 

Application. — Place  the  face  of  the  bandage  intermediate 
to  the  two  rollers  under  the  axilla  of  the  sound  side,  then 
conduct  each  roller  above  the  upper  part  of  the  wound  going 
obliquely  from  below  upwards,  one  behind,  the  other  in  front 
of  the  chest  (1,  1') ;  arrived  there,  change  them  from  hand 
to  hand  for  the  purpose  of  crossing  them;  gain,  from  before 
backwards  with  the  one  held  in  the  right  hand,  the  posterior 
and  inferior  part  of  the  wound  (!'),  conduct  at  the  same  time 
the  one  in  the  left  hand  under  the  sound  axilla,  turn  the  lat- 


36k  OK  njLHHAQtva. . 

ter,  and  come  to  fix  inferiorlj  by  a  horizontal  circular  turn 
of  the  chest  the  first  oblique  or  recurrent  turn  (1'  1')  (2  2) ; 
then  raise  the  latter,  and  after  having  embraced  in  the  form 
of  a  loop  the  turn  (2),  direct  it  obliquely  from  below  upwards 
towards  the  superior  part  of  the  wound  (2'),  where  you  will 
fix  it  with  the  turn  (3)  which  you  will  have  conducted  over  it 
in  parting  from  and  returning  towards  the  sound  axilla  after 
having  covered  successively  from  below  upwards  and  from 
above  downwards  the  posterior  and  anterior  walls  of  the  tho- 
rax (3,  3).  Make  now  a  third  descending  recurrent  (3'),  fix 
it  by  a  second  horizontal  circle  (4),  then  practice  a  fourth  as- 
cending recurrent  (4'),  over  which  you  will  pass  anew  a  turn 
parting  from  and  returning  towards  the  sound  axilla  (5). 
Contiaue  thus  until  the  wound  and 'dressings  have  been  com- 
pletely covered  (5',  6,  6,  7,  7',  8,  8',  9,  9V10,  10',  11,  11'), 
and  terminate  by  making  horizontal  circular  turns  around  the 
chest  with  the  roller  (12).  * 

Uses. — -This  bandage,  as  simple  as  elegant,  is  very  conve- 
nient for  maintaining  topical  applications  or  apparatus,  after 
disarticulation  at  the  shoulder-joint. 

OBLIQUE  SLING  FOR  THE  ARM  AND  CHEST. 
(Plats  9,  Figure  21.) 

Composition.^— A  piece  of  linen  one  yard  square,  folded 
diagonally  into  a  triangle.  ^ 

Application.— The  fore-arm  being  bent  at  a  right  single 
upon  the  arm,  place  the  base  of  the  triangle  under  the  hand 
(a),  directing  the  apex  towards  the  elbow,  then  make  the 
ends  ascend  obliquely,  the  one  in  front  (b)  the  other  behind 
the  chest  to  the  sound  shoulder  where  you  will  tie  them  to- 
gether (c) ;  gather  up  the  angles  at  the  apex  and  carry  them, 
embracing  the  arm  and  elbow  (d,  e,  g,  h),  in  front  of  the 
chest  to  be  secured  by  a  pin  to  the  body  of  the  bandage  (r). 

Z7ses.— This  sling  may  be  applied  over  the  dress-— it  sup- 
ports the  arm  and  fore-arm  perfectly. 

SIMPLE  AND  DOUBLE  T  FOR  THE  HAND. 
(Plate  9»Figurb  28.) 

Composition. — A  bandage  about  three-quarters  of  a  yard 
long  and  a  little  over  an  inch  broad  (a,  a,  minor  figure  28), 


BA?«DAaKS    FOR    UPPRR    EXIRRMITIES.  Jf? 

upon  which  will  be  sewed  perpendicularly  two  other  bandages, 
a  little  shorter  and  proportion  ably  narrower,  one  about  two 
and  a  half  inches  from  the  initial  end  (c,  minor  fig.  28),  and 
the  other  at  nearly  twice  the  distance  from  the  same  end  (b, 
minor  figure  28).  For  the  simple  T  the  two  supplementary 
bands  will  be  replaced  by  a  single  one  which  will  be  sewed 
perpendicularly  upon  the  transverse  band,  but  at  the  distance 
of  about  four  and  a  half  inches  from  the  initial  end. 

Application. — If  you  wish  to  apply  the  double  T,  place  the 
initial  end  of  the  transverse  band  over  the  back  of  the  wrist 
in  such  a  manner  that  the  two  perpendicular  bands  corres- 
pond to  the  interdigital  spaces  of  the  fourth  and  fifth  and 
the  first  and  second  fingers  (a',  a-,  b*,  c\  figure  28) ;  conduct 
this  iatter  one  between  the  thumb  and  the  index  (c\)  the 
other  bgtween  the  ring  and  the  little  finger  (b^),  then  di- 
rect them  towards  the  palmar  face  of  the  wrist,  where  you 
will  fix  them  by  passing  the  transverse  band  circularly  around 
them  (a');  from  thence  bring  them  back  to  the  back  of  the. 
wrist,  traversing  with  the  one  the  third  (B),  and  vf^xh  the 
other  the  second  interdigital  space  (c^).  Fix  this  latter  by 
a  horizontal  circular  turn  (a^),  reverse  it  in  the  form  of  an 
ear  (c^)  over  this  circular,  proceed  to  tic  it  over  the  back  of 
the  wrist  with  the  first  (b),  and  finish  by  fixing  the  terminal 
end  of  the  transverse  band  with  a  pin  (.\^).  The  simple  T 
is  applied  in  the  same  manner,  but  only  two  interdigital 
spaces  are  covered  with  the  perpendicular  band. 

Csfs. — The  double  T  retains  more  firmly  than  the  simple  T 
dressings  over  the  back  and  palm  of  the  hand  ;  both  serve  to 
prevent  union  between  the  fingers,  so  apt  to  take  place  in  the 
cicatrization  from  burns.  The  simple  T  acts  only  upon  two, 
while  the  double  T  acts  upon  the  four  interdigital  spaces. 


BANDAGES  FOR  LOWER  EXTREMITIES, 


SPIRAL  FOR  THE  LOWER  LIMB— (THEDEN'S  BANDAGE.) 
(Plate  10,  Figure  29.)  '" 

Composition. — A  bandage  sixteen  yards  long  and  two 
inches  broad. 

Application. — If  you  wish  to  apply  this  bandage  over  the 
right  limb,  begin  at  the  base  of  the  toes,  making  a  certain 
number  of  turns,  interrupted  by  the  necessary  reverses  (1,  2, 
3,  4,  5,  6,  7,  8).  Having  reached  the  instep,  direct  your 
bandage  obliquely  over  the  summit  of  the  heel  (9),  then 
again  over  the  instep,  from  whence  you  will  come,  passing 
under  the  sole,  to  cover,  in  front  of  the  heel,  the^  anterior 
border  of  the  preceding  turn  (10) ;  then  gain,  obliquely, 
the  upper  part  of  the  tibio-tarsal  articulation  (10,  10),  pass 
behind  the  tendo-Achillis,  and  .cover,  on  the  back  of  the 
heel,  the  posterior  border  of  the  band  9  (11).  From  this 
point,  gain  obliquely  the  instep  (11,  11),  pass  circularly  over 
the  plantar  surface  and  gain,  for  the  fourth  time,  the  instep, 
in  order  to  cross  at  this  point  the  preceding  turn  (12). 
From  the  instep,  direct  yourself  over  the  internal  malleolus, 
behind  the  tendo-Achillis,  pass  from  behind  forwards  and 
transversely  under  the  external  malleolus  (13),  under  the 
sole  of  the  foot,  and  ascend  over  the  instep,  in  order  to  pro- 
ceed from  there  to  cross  from  l)efore  backwards  over  the  ten- 
do-Achillis the  turn  13  (14,  14);  from  the  tendo-Achillis 
come  again  over  the  instep,  pass  over  the  plantar  surface  (15), 
cover  from  before  backwards  and  transversely  the  under  part 
of  the  internal  malleolus,  then  surround  the  leg  circularly 
(16,  17,  18,  19).  That  done,  proceed  with  circular  and- re- 
versed turns  to  the  lower  border  of  the  patella  (20,  20,  21,  21, 
22,  22,  23,  23,  24,  24,  25,  25,  26,  26,  27,  27,  28, 28,  29, 29, 


BAKDAOES   FOR   LOWBR    EXTREMITIES.  39 

30,  30,  31,  32,  33,  34,  35),  which  you  will  cover  by  the  aid 
of  superior  and  inferior  crosses.  To  do  this,  direct  your  ban- 
dage obliquely  from  below  upwards  from  the  upper  and  outer 
part  of  the  leg  towards  the  summit  of  tlie  internal  tuberosity 
of  the  tibia  (36),  surround  the  back  of  the  knee,  and  after 
having  covered  the  external  tuberosity  of  the  tibia,  gain 
obliquely,  by  crossing  the  preceding  oblique  below  the  patella, 
the  upper  and  internal  part  of  the  leg  (37) ;  repeat  this  ope- 
ration two  or  three  times  (38,  39,  40,  41,  42),  then  gain,  by 
crossing  obliquely  the  popliteal  space,  the  outer  and  lower 
part  of  the  thigh,  which  you  will  surround  with  a  horizontal 
circular  (43).  Having  reached  the  outer  and  lower  face  of 
the  thigh,  descend  obliquely  towards  the  internal  condyle  of 
the  femur  f44),  cover  the  knee  behind,  pass  over  the  external 
femoral  condyle  and  gain,  by  crossing  obliquely  from  below 
upwards  above  the  patella  the  turn  (44),  the  inner  and  lower 
face  of  the  thigh  (45).  Make,  in  this  way,  two  or  three 
crosses  (46,  47,  48,  49,  50),  then  unite  them  to  the  inferior 
crosses  by  the  aid  of  a  turn  which,  from  the  ham,  will  pass 
circularly  over  the  patella  (51),  and  ascend  behind  to  the 
lower  and  outer  part  of  the  thigh.  Having  reached  these, 
finish  your  bandage  by  the  aid  of  new  circular  and  reversed 
circumvolutions  covering  the  whole  upper  surface  of  the 
thigh  (51,  52,  53,  54,  55,  56,  56,  57,  57,  58,  58,  59,  59,  60, 
60,  61,  61,  62,  62,  63,  63,  64,  64,  65,  65,  66,  66,  67,  67,  68). 
Uses. — The  spiral  of  the  lower  limb  employed  with  success 
by  Professor  Velpeau  in  the  first  stage  of  diffuse  phlegmon  to 
obtain  resolution  of  the  inflammation  and  disengorgement  of 
the  tissues,  is  often  useful  for  emptying  purulent  depots  and 
facilitating  adhesion  in  the  parts  after  long  and  abundant 
suppurations.  It  is  also  used  for  varicose  veins,  oedema,  and 
especially  for  producing  compression  throughout  the  whole 
extent  of  a  limb  when  it  is  desired  to  treat  aneurismal  tumor 
by  this  means.  Generally  designated  under  such  circumstan- 
ces as  Thedeiis  handagey  it  is  used  with  a  view  to  compress 
the  diseased  points,  to  prevent  the  engorgement  of  parts  sit-* 
uated  below,  and  to  modify  the  flow  of  blood  to  the  tumor;  to 
achieve  the  latter  result,  Theden,  before  applying  the  ban- 
dage, placed  graduated  compress  over  that  portion  of  the  ar- 
tery situated  above  the  aneurism,  and  covered  the  tumor  with 
cloths  saturated  with  his  astringent  wash,  called  eau  d'arque- 
husade. 


40  ON    BANDAGING. 

The^spiral  of  the  lower  limb  works  loose  and  becomes  easily 
deranged ;  it  is  moreover  very  fatiguing  on  account  of  the 
compression  it  produces,  and  which  may  determine  gangrene 
when  it  is  not  evenly  applied.  These  inconveniences  are  ob- 
viated by  remedying  the  inequalities  of  the  limb  with  wadding 
or  tow,  and  securing  the  circumvolutions  by  the  application 
of  starch. 

FIGURE  OF  EIGHT  FOR  THE  LEG  AND  FOOT. 
(Plate  10,  Figurk  30.) 

Composition. — A  bandage  two  and  a  half  yards  long  and 
two  inches  broad. 

Application.- — Place  the  initial  end  three  or  four  fingers 
breadth  above  the  malleoli,  over  the  anterior  part  of  tbe  leg, 
and  fix  it  by  a  horizontal  circular  turn  (1,  2) ;  arrived  above 
the  internal  malleolus,  gain  obliquely  the  articulation  of  the 
fifth  metatarsal  with  the  cuboid  bone  (3),  surround  the  sole 
and  back  of  the  foot  by  a  horizontal  circular  (4)  and  ascend 
obliquely,  crossing  over  the  instep  tlie  preceeding  turn,  to  the 
external  malleolus  (6) ;  make  behind  the  leg  a  horizontal 
semi-circle,  cover  the  instep  again  obliquely  (6)  and  the  plan- 
tar surface  circularly,  then  ascend  again  over  the  external 
malleolus  (7) ;  continue  thus  until  the  small  compress  which 
you  have  previously  placed  over  the  vein  is  firmly  fixed,  and 
finish  by  horizontal  circular  turns  around  the  leg  with  the 
roller  (8> 

f '6^^8.— This  bandage  may  be  used  for  maintaining  dressings 
over  the  dorsal  and  plantar  aspects  of  the  foot,  and  also  over 
the  tibio-tarsal  articulation,  but  is  more  particularly  resorted 
to  for  compressing  the  opening  in  the  saphenous  vein  after 
bleeding  from  the  foot. 

POSTERIOR  FIGURE  OP  EIGHT  FOR  THE  K.^EE, 
(Plate  10,  Figure  31.) 

Composition-— k  bandage  four  yards  long  and  two  inches 
broad. 

Application, — Fix  the  initial  end  by  a  horizontal  circular 
turn  above  the  knee  (1,  2) ;  having  arrived  above  the  exter- 
nal condyle  of  the  femur,  descend  obliquely  behind  the  ham 
to  the  internal  tuberosity  of  the  tibia  (3) ;  surround  the  upper 


BANDAGES    FOR    LOWER    EXTREMITIES  41 

part  of  the  leg  with  a  horizontal  circle  (4),  then  ascend 
obliquely,  crossiog  like  the  letter  X  over  the  popliteal  space  the 
preceding  oblique,  as  far  as  the  iuternal  condyle  of  the  femur 
(5);  make  a  horizontal  semi-circle  over  the  anterior  and  lower 
part  of  the  thigh,  pass  again  obliquely  over  the  ham  (6),  cir- 
cularly over  the  anterior  and  upper  part  of  the  leg,  ascend 
again  over  the  internal  condyle  of  the  femur  (7),  and  continue 
thus  to  the  entire  expending  of  the  bandage  (8). 

Usf's. — This  bandage  is  employed  for  dressings  over  the 
ham ;  it  may  be  also  used  for  compressing  the  popliteal  artery 
affected  with  spontaneous  or  traumatic  aneurism. 

RECURRENT  OR  CAPELINE  FOR  AN  AMPUTATED  THIGH. 

(Plate  11,  Figure  32.) 

Composition. — A  bandage  twelve  yards  long  and  about  two 
inches  broad. 

Application. — The  amputation  terminated,  the  wound  co- 
vered with  lint,  and  this  sustained  by  a  compress,  .shaped 
like  a  Maltese  cross,  fix  the  initial  end  above  the  stump  by 
several  horizontal  circular  turns  (1,  2,  3,  4);  arrived  over  the 
external  side  of  the  thigh  (we  suppose  it  to  be  the  right;,  re- 
verse the  bandage  from  above  downwards  (5),  so  as  to  make 
a  turn  descend  over  the  wound,  cover  it  across  and  ascend 
over  the  opposite  side  of  the  limb  (6,  6,  6).  That  done,  prac- 
tise a  second  reverse,  but  this  time  from  left  to  right  and  from 
before  backwards,  which  will  permit  you  to  cover  circularly, 
in  fixing  the  two  reverses,  the  posterior,  external  and  anterior 
aspects  of  the  thigh  (7,  8,  9).  Having  reached  the  middle 
part  of  the  latter,  make  a  third  reverse  in  the  direction  of  the 
tirst  (10),  then  a  second  recurrent,  which  you  will  conduct, 
by  crossing  the  recurrent  (6)  at  a  right  angle  over  the  middle 
of  the  stump,  to  the  posterior  face  of  the  thigh  (10);  then 
practise,  from  right  to  left,  a  fourthTeverse  and  two  circulars 
(11,  12);  then,  when  you  shall  have  arrived  at  the  outer  side 
of  the  third  reverse  (lOj,  commence  a  fifth  reverse  (13)  and 
a  third  recurrent,  whidh  will  cover  two-thirds  of  the  second 
on  the  outside,  and  Hke  it  will  be  directed  from  the  front  to 
the  posterior  of  the  wound  (13);  maintain  this  anew  by  two 
circular  turns  (14,  15),  and  continue  in  this  way  your  circu- 
lars and  recurronts  alternately  until  the  stump  is  entirely 
covered  (16,  16,  17,  18,  19,  19,  20,  21,  22,  22,  23,  24,  25). 


42  O^   BANDAGINCJ. 

Finisli  by  ascending  and  descending  turns,  if  the  amputation 
has  been  practised  at  the  lower  part  of  the  thigh,  or  by  circles 
around  the  pelvis,  if  the  limb  has  been  ablated  high  up,  in 
order  to  avoid  derangement  of  the  apparatus  by  the  move- 
ments of  the  patient. 

The  capeline  for  amputations  of  the  thigh  may  be  applied 
as  follows,  with  the  double-headed  rollers  unequal  in  their 
size,  the  larger  serving  for  the  circulars  and  the  smaller  for 
the  recurrents. 

Place  the  intermediate  face  of  the  bandage  over  the  ante- 
rior face  of  the  member  above  the  stump,  then  direct  them 
over  the  opposite  face,  where  you  will  cross  them  ;  pass  again 
over  the  a»terior  and  posterior  aspects,  making,  in  this  way, 
three  or  four  circular  turns,  in  order  to  secure  the  commence- 
ment of  the  bandage.  When  the  latter  reaches  one  of  the 
sides  of  the  limb,  reverse  the  turn  which  k  above,  and  con- 
duct it  from  above  downwards,  over  the  most  superficial,  to 
form  a  recurrent,  which  you  will  direct  transversely  over  the 
wound,  from  the  outer  to  the  inner  side,  if  the  bandage  is 
applied  to  the  right  thigh.  Fix  this  recurrent  by  a  circular 
turn,  then  practise  a  second,  which  will  pass  from  before 
backwards,  and  cross  the  first  over  the  wound  -,  confine  this 
second  recurrent  by  a  circular,  continue  in  this  way  until  the 
wound  is  completely  covered,  and  terminate  with  the  most 
voluminous  roller,  as  we  have  indicated  for  the  capeline  with 
the  single  roller. 

The  latter  capeline  is  almost  entirely  abandoned  because 
of  its  application  being  more  difficult  than  the  other;  it  may, 
however,  be  usefully  employed  in  armies ;  it  ofi"ers,  in  effect, 
much  more  solidity,  an  advantage  which  deserves  to  be  taken 
into  consideration  when  the  patient  has  to  be  subjected  to 
rough  transportation.  ' 

INVAGINATED  OR   UNITING   BANDAGE   FOR  TRANSVERSE 
WOUNDS. 

(Plate  11,  Figure  33.) 

Composition. — 1st.  Two  pieces  of  linen  equal  in  width  to 
the  length  of  the  wound,  and  each  as  long  as  the  space  com- 
prised between  the  fold  of  the  groin  and  the  lower  part  of  the 
leg,  when  the  solution  of  continuity  to  be  re-united  is  trans- 
versely across  the  anterior  region  of  the  thigh.     One  of  these 


is  to  be  split  at  one  of  its  extreTnities,  and  about  the  third  of 
its  length,  into  two  or  three  equi-distant  tails ;  while  in  the 
other,  at  its  centre,  and  in  the  direction  of  its  length,  is  made 
a  number  of  slits  equal  to  the  tails  of  the  other.  2d.  A 
bandage  eighteen  yards  long  and  two  inches  wide.  3d.  Two 
graduated  prismatic  compresses  made  a  little  longer  than  the 
solution  of  continuity. 

AppUcntiov . — The  limb  being  in  a  position  indicated  by 
the  wound,  place  over  the  anterior  surface  of  the  leg,  and  fol- 
lowing its  length,  the  split  piece  of  linea  in  such  a  way  that 
the  ends  shall  be  turned  upwards  and  the  roots  correspond  to 
the  wound  (a,  a',  a'^);  let  it  be  held  in  this  position  by  an 
assistant,  while  you  apply  a  roller  bandage  around  the  leg  to 
within  two  inches  of  the  solution  of  continuity  (1,  2,  3,  4,  4, 
r>,  5,  6,  6,  7,  7,  8,  S,  9,  9,  10,  10,  11,  11,  12,*13,  14,  15,  16, 
17).  Then  confide  the  roller  to  the  assistant,  and  apply  the 
second  piece  of  linen  over  the  anterior  portion  of  the  thigh 
in  such  a  way  that  the  slits  shall  reach  the  level  of  the  wound 
(b,  b',  b'^,  c)  ;  take  the  roller  from  the  assistant,  in  order  that 
he  may  take  charge  of  the  latter  piece  of  linen  and  secure 
it  by  a  spiral  of  the  thigh  (18, 19,  19,  20,  20,  21,  21,  22,  22, 
23,  23,  24,  25,  26,  26,  27,  27).  That  done,  confide  again  the 
roller  (28)  to  the  assistant,  place  the  graduated  compress  over 
the  edges  of  the  division  (d,  d',  e,  e'),  pass  the  tails  (a',  a*) 
through  the  slits  (b^,  b^),  draw  them  in  opposite  directions 
until  the  edges  of  the  wound  are  co-aptated,  and  fix  the  two 
pieces  of  linen  in  this  position  by  a  spiral,  descending  from 
the  upper  part  of  the  thigh  to  the  roots  of  the  toes  and  cover- 
ing the  limb  evenly. 

U>ies, — Although  constructed  upon  good  principles,  this 
bandage  is  rarely  used  to  obtain  union  in  transverse  wounds  of 
the  limbs,  for  it  can  nearly  always  be  replaced  by  more  simple 
means.  Applied  over  the  upper  extremities,  it  serves  for  the 
treatment  of  fractures  of  the  olecranon,  and  over  the  lower 
extremities  for  fracture  of  the  patella. 

TARSO-PATELLA  CRAVAT. 

(Plate  12,  Figure  34.) 

'  Composition. — Three  cravats  one  yard  in  length. 
Application. — Place  one  of  the  cravats,  in  the  form  of  a 
stirrup,  over  the  inst«p,  and  tie  its  ends  together  over  the 


44  OK    BANDAame.- 

plantar  region  (h,  I,  j) ;  fix  another  over  the  lower  third  of 
the  thigh  and  the  upper  third  of  the  leg  (a,  b,  b^,  c,  c^;  d)j 
then  introduce  at  the  instep,  under  the  ring  formed  by  the 
first  (e),  a  third  cravat ;  carry  the  ends  directly  towards  the 
upper  and  lateral  portions  of  the  knee  (g,  f),  and  faslen  them 
on  each  side  to  the  super  and  sub-patella  cravat  (g^). 

Uses. — Proposed  by  M.  Mayor  for  fractures  of  the  patella 
and  rupture  of  the  tendon,  which  fixes  this  bone  to  the  tibia, 
this  apparatus  will  also  serve  for  approximating  the  lips  of 
transverse  wounds  of  the  instep,  of  the  leg,  and  of  the  knee. 

TRIANGULAR  CAP  FOR  THE  STUMP. 
(Plate  12,  Figure  35  ) 

Composition.— A  triangle  one  yard  long  from  end  to  end, 
and  half  a  yard  deep  from  apex  to  base. 

Application.— l^hce  the  middle  of  the  base  of  the  triangle 
over  the  anterior  face  of  the  limb  at  a  convenient  distance 
from  the  end  of  the  stump  (a),  direct  and  cross  under  the 
limb  the  two  ends  corresponding  to  this  base  (b,  c),  then 
bring  them  forward  for  the  purpose  of  securing  them  (b^,  c^); 
then  fold  the  apex  of  the  triangle  over  the  end  of  the  stump 
and  attach  it  in  front  with  a  pin  (d). 

The  tendency  of  this  cravat  to  slip  and  become  disarranged 
when  placed  over  a  coolcal  stump  may  be  prevented  in  the 
following  manner :  1st.  For  the  thigh,  by  means  of  a  band 
going  directly  from  the  apparatus  to  a  band  around  the  waist; 
or  otherwise,  by  directing  the  two  ends  of  the  handkerchief, 
after  liaviog  crossed  them  in  front  of  the  limb,  to  the  waist- 
band. 2d.  For  the  ar/ii,  the  triangle  may  be  fastened  around 
the  neck  or  the  axilla  of  the  sound  side.  3d.  For  the  fore- 
arm and  the  leg,  the  two  extremities  may  be  carried  around 
the  elbow  or  the  knee. 

Uses. — This  triangle  is  very  convenient  for  the  dressing  of 
amputations;  it  may  advantageously  take  the  place  of  the 
numerous  turns  of  bandage  required  for  the  application  of 
the  capeline. 

SCAPULO-TIBIAL  OR  TIBIAL  SLING. 
(Plate  12,  Figure  36.) 
Composition. — 1st.  A  scarf  two  yards  long ;  a  triangle  one 


BANDAGES    FOR    I^JWER     EXTREMITIES.  40 

and  a  half  yards  from  end  to  end  and  three-quarters  of  a  yard 
from  base  to  apex. 

Ai^pUcatlon. — Place  the  base  of  the  triangle  over  the  ante- 
rior and  inferior  portion  of  the  leg  (a),  take  the  ends  (b), 
and,  after  having  passed  one  of  them  through  the  ring  of  the 
shoulder-band  (e,  f,  g,  h,)  tie  them  together  at  the  level  of 
the  right  or  left  flank  (c),  then  fold  the  apex  over  the  side 
of  the  knee  (l^). 

U^€s. — This  sling  may  be  employed  in  all  eases  where  it  is 
necessary  to  maintain  the  leg  flexed  upon  the  thigh.  It  main- 
tains flexion,  and  at  the  same  time  enables  the  patient  to  go 
about. 


1 


EXPLANATION^  OF  PLATES. 


PLATE  1. 

Fig.  1.  ^fanne^  of  commencing  the  application  of  the  single- 
headed  roller:  A,  extremity  of  the  thumb,  and  the  index  and 
middle  fingers  of  the  right  hand,  maintaining  the  roller;  B,  thumb 
and  index  finger  of  the  left  hand  fixing  the  initial  end. 

Fig.  2.  Manner  of  making  a  reverse :  A,  left  thumb  placed  over 
the  external  face  of  the  band,  and  assisting  to  make  the  fold  con- 
stituting the  reverse. 

Fig.  3,    Manner  of  applying  a  double-headed  roller. 


PLATE  2. 

Fig.  4.   Cross  for  one  eye  (first  variety;. 

Fig.  .'j.    The  same  bandage  (second  variety). 

Fig.  6.    Cross  for  both  eyes,  with  one  roller. 

Fig.  7.    The  same  bandage  with  the  double  roller. 

Fig.  7  (minor).  Manner  of  making  the  reverse  behind  in  the  ap- 
plication of  the  double  roller  in  general,  and  in  the  cross  for  both 
eyes  in  particular. 

PLATR  3. 

Fig.  8.    Simple  cross  for  the  lower  jaw. 
Fig.  9.    Double  cross  for  the  lower  jaw,  with  ene  roller. 
Fig.  10.   The  same  bamlage  with  double  roller. 
Fig.  10  (minor).    Manner  of  making  the  reverse  over  the  chin  in 
the  double  cross  for  the  lower  jaw,  with  the  double  roller. 
Fig.  11.   Cross  for  the  head. 


PLATE  4. 

Fig.  12.  Knotted  bandage  for  the  head  (Baler's  knot). 

Fig.  1.3.  Recurrent  or  capeline  for  the  head. 

Fig.  14.  Double  T  for  the  nose. 

Fig.  15,  Invaginated  or  uniting  bandage  for  vertical  wounds  of 
the  lip. 


48  EXPLANATION    OF    PLATE8, 


PLATE  5. 


Fig.  IG.   Figure  of  eight  for  one  sheulder  and  the  opposite  axilla. 
Fig.  17,    Anterior  figure  of  eight  for  the  shoulders^ 

PLATE  6. 

Fig.  18.   Cross  for  the  groins  (spica  for  both  groins). 
Fig.  19.   Cross  for  the  groin  (spica  for  the  groin). 

PLATE  7. 

Fig.  20.  Spiral  for  one  finger. 

Fig.  21.  Sf?Iral  for  the  fingers  and  hand. 

Fig.  22.  Figure  of  eight  for  the  thumb  and  wrist  (spica  for  the 
thumb). 

Fig.  23.  Posterior  figure  of  eight  for  the  hand  and  wrist. 

PLATE  8. 

Fig.  24.  Figure  of  eight  for  the  elbow. 

Fig.  25.  Figure  of  eight  for  extending  the  hand  upon  the  elbow. 

Fig.  26.  Recurrent  or  capeline  for  disarticulation  at  the  shoulder- 
joint. 

PLATE  0. 

Fig.  27.    Oblique  sling  for  the  arm  and  chest 

Fig.  28.    Double  T  of  the  hand  applied. 

Fig.  28  (minor).    Double  T  of  the  hand  before  its  application. 

PLATE  10. 

Fig.  29.    Spiral  for  the  lower  limb  (Theden's  bandage). 
Fig.  30.   Figure  of  eight  for  the  foot  and  leg. 
Fig.  31.   Posterior  figure  of  eight  for  the  knee. 

PLATE  11. 

Fig.  32.   Pvecurrent  or  capeline  for  amputation  of  the  thigh. 
Fig.  33.   Invaginated  or  uniting  bandage  for  transverse  wounds. 

'      '  PLATE  12. 

Fig.  34.    Tarso-patella  cravat. 

Fig.  85.    Triangular  cap  for  the  stump. 

Fig.  36.   Scapulo-tibial  or  tibial  sling. 


BANDAGES 


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